The feasibility of using electrical impedance tomography to guide positive pressure airway clearance in children with cystic fibrosis and tracheobronchomalacia.

Aim: Positive expiratory pressure devices are frequently used for airway clearance in children with cystic fibrosis and tracheobronchomalacia. This study aimed to establish if electrical impedance tomography is a feasible measure to titrate pressures in non-sedated children. Method: Ten children with cystic fibrosis and tracheobronchomalacia performed airway clearance using positive pressure devices whilst monitored with electrical impedance tomography. Feasibility was measured as tolerability and completion of the intervention; ease of administration and interpretation of software data; ability to determine differences in regional lung ventilation; and compatibility for use in the clinic. A pre-determined score of ≥70% was deemed successful for each measure and reported as means and ranges. Results: Criterion met success for tolerability (98%; 86-100) and intervention completion (95%; 90-100). Regions of interest display (96%; 80-100) and software data analysis (96%; 90-100) allowed regional lung ventilation changes to be observed with different pressures. Ease of administration and compatibility for the clinic highlighted difficulties with automated software functionality and clinician time (66%; 10-100% and 75%; 0-100). Conclusion: Use of electrical impedance tomography is feasible in non-sedated children with cystic fibrosis. It has potential as a tool for guiding positive pressure titration for airway clearance. Results and application to clinical practice require further study.