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Response to Letter to Editor: Electrical impedance tomography and inspiratory muscle training in ICU patients

      Thank you for the opportunity to respond to the interesting letter from Zhao et al. about the potential role of electrical impedance tomography (EIT) in inspiratory muscle training (IMT) in intensive care unit (ICU) patients.
      • Zhao Z.
      • Frerichs I.
      • Chang M.-Y.
      • Möller K.
      Inspiratory muscle training can be monitored by electrical impedance tomography.
      We agree that EIT may prove a vital adjunct to the toolbox for ICU clinicians. For example, EIT has already been used to identify changes in distribution of ventilation during airway suction.
      • Corley A.
      • Sharpe N.
      • Caruana L.R.
      • Spooner AJ
      • Fraser JF
      Lung volume changes during cleaning of closed endotracheal suction catheters: a randomized crossover study using electrical impedance tomography.
      However most ICUs do not yet have access to this technology, and our guideline was written for simplicity and generalisability. There may well be a role for EIT in research into the mechanisms of weaning failure and the efficacy of IMT in ICU patients, although we suspect that identification of muscle fatigue will not necessarily predict successful IMT.
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      References

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        • Frerichs I.
        • Chang M.-Y.
        • Möller K.
        Inspiratory muscle training can be monitored by electrical impedance tomography.
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      Linked Article

      • Inspiratory muscle training can be monitored by electrical impedance tomography
        Australian Critical CareVol. 32Issue 2
        • Preview
          We read with interest the article by Bissett et al. using the high-intensity approach for inspiratory muscle training (IMT) in patients with prolonged mechanical ventilation.1 Because IMT does not necessarily improve clinical outcomes,2 Bissett et al. proposed a list of indications when to apply IMT including patients awareness, fraction of inspired oxygen, and respiratory rate, which are not direct measures of muscle activities. The training intensity can be monitored with maximum inspiratory pressure, which needs to be measured invasively through the tracheostomy or using an endotracheal tube and not suitable for patients who are recently weaned.
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