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Article ; Online: COVID-19 Pneumonia Phenotypes Detection with Electrical Impedance Tomography

Chen Rongqing / Lovas András / Benyó Balázs / Moeller Knut

Current Directions in Biomedical Engineering, Vol 8, Iss 2, Pp 707-

2022 Volume 710

Keywords	Medicine ; R
Language	English
Publishing date	2022-09-01T00:00:00Z
Publisher	De Gruyter
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Electrical Impedance Tomography might be a Practical Tool to Provide Information about COVID-19 Pneumonia Progression

Chen Rongqing / Lovas András / Benyó Balázs / Moeller Knut

Current Directions in Biomedical Engineering, Vol 7, Iss 2, Pp 276-

2021 Volume 278

Abstract: COVID-19 induced acute respiratory distress syndrome (ARDS) could have two different phenotypes, which might have different response and outcome to the traditional ARDS positive end-expiration pressure (PEEP) treatment. The identification of the ... ...

Abstract	COVID-19 induced acute respiratory distress syndrome (ARDS) could have two different phenotypes, which might have different response and outcome to the traditional ARDS positive end-expiration pressure (PEEP) treatment. The identification of the different phenotypes in terms of the PEEP recruitment can help improve the patients’ outcome. In this contribution we reported a COVID-19 patient with seven-day electrical impedance tomography monitoring. From the conductivity distribution difference image analysis of the data, a clear course developing trend can be observed in addition to the phenotype identification. This case might suggest that EIT can be a practical tool to identify phenotypes and to provide progressive information of COVID-19 pneumonia.
Keywords	electrical impedance tomography ; covid-19 pneumonia ; progressive information ; monitoring ; ards ; Medicine ; R
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	De Gruyter
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Detection of Different COVID-19 Pneumonia Phenotypes with Estimated Alveolar Collapse and Overdistention by Bedside Electrical Impedance Tomography.

Chen, Rongqing / Lovas, András / Benyó, Balázs / Möller, Knut

IFAC-PapersOnLine

2021 Volume 54, Issue 15, Page(s) 269–274

Abstract: COVID-19 induced acute respiratory distress syndrome (ARDS) could have two different phenotypes, which was reported to have different response and outcome to the typical ARDS positive end-expiration pressure (PEEP) treatment. The identification of the ... ...

Abstract	COVID-19 induced acute respiratory distress syndrome (ARDS) could have two different phenotypes, which was reported to have different response and outcome to the typical ARDS positive end-expiration pressure (PEEP) treatment. The identification of the different phenotypes in terms of the recruitability can help improve the patient outcome. In this contribution we conducted alveolar overdistention and collapse analysis with the long term electrical impedance tomography monitoring data on two severe COVID-19 pneumonia patients. The result showed different patient reactions to the PEEP trial, revealed the progressive change in the patient status, and indicted a possible phenotype transition in one patient. It might suggest that EIT can be a practical tool to identify phenotypes and to provide progressive information of COVID-19 pneumonia.
Language	English
Publishing date	2021-11-02
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2839185-8
ISSN	2405-8963 ; 2405-8963
ISSN (online)	2405-8963
ISSN	2405-8963
DOI	10.1016/j.ifacol.2021.10.267
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Structural priors represented by discrete cosine transform improve EIT functional imaging.

Chen, Rongqing / Krueger-Ziolek, Sabine / Lovas, András / Benyó, Balázs / Rupitsch, Stefan J / Moeller, Knut

PloS one

2023 Volume 18, Issue 5, Page(s) e0285619

Abstract: Structural prior information can improve electrical impedance tomography (EIT) reconstruction. In this contribution, we introduce a discrete cosine transformation-based (DCT-based) EIT reconstruction algorithm to demonstrate a way to incorporate the ... ...

Abstract	Structural prior information can improve electrical impedance tomography (EIT) reconstruction. In this contribution, we introduce a discrete cosine transformation-based (DCT-based) EIT reconstruction algorithm to demonstrate a way to incorporate the structural prior with the EIT reconstruction process. Structural prior information is obtained from other available imaging methods, e.g., thorax-CT. The DCT-based approach creates a functional EIT image of regional lung ventilation while preserving the introduced structural information. This leads to an easier interpretation in clinical settings while maintaining the advantages of EIT in terms of bedside monitoring during mechanical ventilation. Structural priors introduced in the DCT-based approach are of two categories in terms of different levels of information included: a contour prior only differentiates lung and non-lung region, while a detail prior includes information, such as atelectasis, within the lung area. To demonstrate the increased interpretability of the EIT image through structural prior in the DCT-based approach, the DCT-based reconstructions were compared with reconstructions from a widely applied one-step Gauss-Newton solver with background prior and from the advanced GREIT algorithm. The comparisons were conducted both on simulation data and retrospective patient data. In the simulation, we used two sets of forward models to simulate different lung conditions. A contour prior and a detail prior were derived from simulation ground truth. With these two structural priors, the reconstructions from the DCT-based approach were compared with the reconstructions from both the one-step Gauss-Newton solver and the GREIT. The difference between the reconstructions and the simulation ground truth is calculated by the ℓ2-norm image difference. In retrospective patient data analysis, datasets from six lung disease patients were included. For each patient, a detail prior was derived from the patient's CT, respectively. The detail prior was used for the reconstructions using the DCT-based approach, which was compared with the reconstructions from the GREIT. The reconstructions from the DCT-based approach are more comprehensive and interpretable in terms of preserving the structure specified by the priors, both in simulation and retrospective patient data analysis. In simulation analysis, the ℓ2-norm image difference of the DCT-based approach with a contour prior decreased on average by 34% from GREIT and 49% from the Gauss-Newton solver with background prior; for reconstructions of the DCT-based approach with detail prior, on average the ℓ2-norm image difference is 53% less than GREIT and 63% less than the reconstruction with background prior. In retrospective patient data analysis, the reconstructions from both the DCT-based approach and GREIT can indicate the current patient status, but the DCT-based approach yields more interpretable results. However, it is worth noting that the preserved structure in the DCT-based approach is derived from another imaging method, not from the EIT measurement. If the structural prior is outdated or wrong, the result might be misleadingly interpreted, which induces false clinical conclusions. Further research in terms of evaluating the validity of the structural prior and detecting the outdated prior is necessary.
MeSH term(s)	Humans ; Tomography/methods ; Retrospective Studies ; Image Processing, Computer-Assisted/methods ; Electric Impedance ; Tomography, X-Ray Computed ; Algorithms
Language	English
Publishing date	2023-05-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0285619
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Long term EIT based compliance monitoring in COVID-19 patients

Isasa Reinoso Imanol / Chen Rongqing / Lovas András / Moeller Knut

Current Directions in Biomedical Engineering, Vol 7, Iss 2, Pp 323-

2021 Volume 326

Abstract: The COVID-19 is a viral infection that causes respiratory complications. Infected lungs often present ground glass opacities, thus suggesting that medical imaging technologies could provide useful information for the disease diagnosis, treatment, and ... ...

Abstract	The COVID-19 is a viral infection that causes respiratory complications. Infected lungs often present ground glass opacities, thus suggesting that medical imaging technologies could provide useful information for the disease diagnosis, treatment, and posterior recovery. The Electrical Impedance Tomography (EIT) is a non-invasive, radiationfree, and continuous technology that generates images by using a sequence of current injections and voltage measurements around the body, making it very appropriate for the study to monitor the regional behaviour of the lung. Moreover, this tool could also be used for a preliminary COVID-19 phenotype classification of the patients. This study is based on the monitoring of lung compliances of two COVID-19-infected patients: the results indicate that one of them could belong to the H-type, while the other is speculated belongs to L-type. It has been concluded that the EIT is a useful tool to obtain information regarding COVID-19 patients and could also be used to classify different phenotypes.
Keywords	electrical impedance tomography ; phenotype ; lung compliance ; covid-19 pneumonia ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	De Gruyter
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: EIT based intrathoracic pulsatile impedance measurements during apnea

Krueger-Ziolek Sabine / Lovas András / Hawchar Fatime / Laufer Bernhard / Moeller Knut

Current Directions in Biomedical Engineering, Vol 6, Iss 3, Pp 52-

a case study

2020 Volume 55

Abstract: Intrathoracic ventilation related and pulsatile (perfusion) impedance changes can be measured by the noninvasive and radiation-free imaging method Electrical Impedance Tomography (EIT). Ventilation monitoring is still the key research area in EIT, ... ...

Abstract	Intrathoracic ventilation related and pulsatile (perfusion) impedance changes can be measured by the noninvasive and radiation-free imaging method Electrical Impedance Tomography (EIT). Ventilation monitoring is still the key research area in EIT, whereby perfusion monitoring gain more and more in interest. However, there are still many unknown influencing factors concerning pulsatile impedance measurements which have to be investigated. Hence, in this observational case study the impact of prolonged apnea periods on pulsatile impedance changes was examined in a patient with suspected brain death undergoing several apnea tests. In addition, the correlation between changes in pulsatile impedance and certain blood gas parameters (carbon dioxide partial pressure, pCO2; oxygen partial pressure, pO2; pH; bicarbonate, HCO3 -) were explored. Results show that the pulsatile impedance signal changes over time during apnea. An increase in the area under the curve (Mean AuC) and the maximum amplitude (Mean Max) of heart beat associated impedance signals was observed (Mean AuC: up to 65 %; Mean Max: up to 57 %). Furthermore, a positive correlation between the increase in impedance and pCO2and HCO3 - was assessed (both: up to 0.99), whereas pO2and pH show a negative correlation (both: up to -0.99). These preliminary results indicate that pulsatile EIT monitoring may be applied to get additional information regarding cardio-pulmonary interactions sustaining diagnosis or treatment of lung diseases.
Keywords	electrical impedance tomography ; pulsatile impedance changes ; apnea ; blood gas analysis ; Medicine ; R
Subject code	610
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	De Gruyter
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Differentiating Phenotypes of Coronavirus Disease-2019 Pneumonia by Electric Impedance Tomography.

Lovas, András / Chen, Rongqing / Molnár, Tamás / Benyó, Balázs / Szlávecz, Ákos / Hawchar, Fatime / Krüger-Ziolek, Sabine / Möller, Knut

Frontiers in medicine

2022 Volume 9, Page(s) 747570

Abstract: Introduction: Coronavirus disease-2019 (COVID-19) pneumonia has different phenotypes. Selecting the patient individualized and optimal respirator settings for the ventilated patient is a challenging process. Electric impedance tomography (EIT) is a real- ...

Abstract	Introduction: Coronavirus disease-2019 (COVID-19) pneumonia has different phenotypes. Selecting the patient individualized and optimal respirator settings for the ventilated patient is a challenging process. Electric impedance tomography (EIT) is a real-time, radiation-free functional imaging technique that can aid clinicians in differentiating the "low" (L-) and "high" (H-) phenotypes of COVID-19 pneumonia described previously. Methods: Two patients ("A" and "B") underwent a stepwise positive end-expiratory pressure (PEEP) recruitment by 3 cmH Results: Patients "A" and "B" had a 7- and 12-day long trial, respectively. At the daily baseline, patient "A" had significantly higher compliance: mean ± Conclusion: Patient "B" was recognized as H-phenotype with high elastance, low compliance, higher recruitability, and low ventilation-to-perfusion ratio; meanwhile patient "A" was identified as the L-phenotype with low elastance, high compliance, and lower recruitability. Observation by EIT was not just able to differentiate the two phenotypes, but it also could follow the transition from L- to H-type within patient "A." Clinical trial registration: www.ClinicalTrials.gov, identifier: NCT04360837.
Language	English
Publishing date	2022-05-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.747570
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Article ; Online: Haemodynamic Effects of Lung Recruitment Manoeuvres.

Lovas, András / Szakmány, Tamás

BioMed research international

2015 Volume 2015, Page(s) 478970

Abstract: Atelectasis caused by lung injury leads to increased intrapulmonary shunt, venous admixture, and hypoxaemia. Lung recruitment manoeuvres aim to quickly reverse this scenario by applying increased airway pressures for a short period of time which meant to ...

Abstract	Atelectasis caused by lung injury leads to increased intrapulmonary shunt, venous admixture, and hypoxaemia. Lung recruitment manoeuvres aim to quickly reverse this scenario by applying increased airway pressures for a short period of time which meant to open the collapsed alveoli. Although the procedure can improve oxygenation, but due to the heart-lung and right and left ventricle interactions elevated intrathoracic pressures can inflict serious effects on the cardiovascular system. The purpose of this paper is to give an overview on the pathophysiological background of the heart-lung interactions and the best way to monitor these changes during lung recruitment.
MeSH term(s)	Animals ; Heart/physiopathology ; Hemodynamics/physiology ; Humans ; Positive-Pressure Respiration/methods ; Pulmonary Alveoli/physiopathology ; Pulmonary Atelectasis/physiopathology ; Respiration
Language	English
Publishing date	2015
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2698540-8
ISSN	2314-6141 ; 2314-6133
ISSN (online)	2314-6141
ISSN	2314-6133
DOI	10.1155/2015/478970
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Article ; Online: Importance of the imaging techniques in the management of COVID-19-infected patients

Lovas, András / Hankovszky, Péter / Korsós, Anita / Kupcsulik, Szilvia / Molnár, Tamás / Szabó, Zsolt / Babik, Barna

Orvosi hetilap

2020 Volume 161, Issue 17, Page(s) 672–677

Abstract: Critical-care physicians are facing a challenging process in healthcare due to the overwhelming case number of hypoxic respiratory failure patients. Pneumonia has an utmost importance in the primary pathomechanism of the development of critical illness ... ...

Title translation	[A képalkotó diagnosztika jelentősége a COVID–19-fertőzött betegek ellátásában]
Abstract	Critical-care physicians are facing a challenging process in healthcare due to the overwhelming case number of hypoxic respiratory failure patients. Pneumonia has an utmost importance in the primary pathomechanism of the development of critical illness in the COVID-19 patients. Thus, imaging techniques are situated in the frontline to aim the diagnostic decision-making, to follow up the progress and to evaluate the possible complications. Reviewing the available literature, so far the common chest CT, chest X-ray and chest wall ultrasound features are presented, and recommendations are pronounced for the indications of the different modalities. At the initial phase, the atypical presentations of the virus infection are multiplex, peripheral ground glass opacities situated in the right lower lobe of the lung evolving rapidly into a bilateral involvement of the middle and basal zones. Along with the progression, the ratio of the consolidation is increasing subsequently deteriorating into fibrosis with reticular pattern. Chest ultrasound performed at the bedside has a paramount importance to reduce the possible number of health-care worker contacts in consequence of the strict and special infection control orders established on account of the SARS-CoV-2 pandemia. Orv Hetil. 2020; 161(17): 672–677.
MeSH term(s)	Betacoronavirus ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Coronavirus Infections/diagnostic imaging ; Disease Progression ; Humans ; Pandemics ; Pneumonia, Viral/diagnostic imaging ; Point-of-Care Systems ; Radiography, Thoracic ; SARS-CoV-2 ; Tomography, X-Ray Computed ; Ultrasonography
Keywords	covid19
Language	Hungarian
Publishing date	2020-04-01
Publishing country	Hungary
Document type	Journal Article ; Review
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2020.31814
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Article ; Online: Diagnostic consideration and bedside estimation of the prognosis in COVID-19 patients

Korsós, Anita / Kupcsulik, Szilvia / Lovas, András / Hankovszky, Péter / Molnár, Tamás / Szabó, Zsolt / Babik, Barna

Orvosi hetilap

2020 Volume 161, Issue 17, Page(s) 667–671

Abstract: In December 2019, a cluster of pneumonia cases of unknown origin occured in Wuhan, China. The identified infective agent is a novel corona virus called “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2) and the respiratory disease caused by ... ...

Title translation	[Diagnosztikus lépések és a betegség prognózisának becslése COVID–19-fertőzött betegeken]
Abstract	In December 2019, a cluster of pneumonia cases of unknown origin occured in Wuhan, China. The identified infective agent is a novel corona virus called “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2) and the respiratory disease caused by this agent aquired the name “coronavirus disease 2019” (COVID-19). In March 2020, the World Health Organization (WHO) declared the novel coronavirus outbreak a pandemic. We reviewed the international literature regarding the novel coronavirus outbreak. Here below, we focus mainly on the diagnostic issues of COVID-19 and on the estimation of the prognosis. We detail the relevant anamnestic factors and initial examination results which serve as basics for the clinical suspicion of COVID-19. We also focus on the proper method of microbiological sampling and the relevant informations regarding diagnostic tests like the gold standard real-time reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2. We also cite the current national epidemiologic regulations of testing for novel coronavirus. In the last section, we emphasize the importance and the potential way of early identification of high-risk patients. The COVID-19 pandemic may cause substantial epidemiological and healthcare burden even in Hungary. In addition to the epidemiologic interventions aiming the deceleration of the outbreak, the early identification and the correct hospital treatment remain key issues since these may influence mortality. The chances of the critically ill patients could be improved solely by a high-quality and careful critical care. It is prudent to meet the experiences of colleagues working hard with these patients in the already heavily infected countries. Orv Hetil. 2020; 161(17): 667–671.
MeSH term(s)	Betacoronavirus/genetics ; Betacoronavirus/isolation & purification ; COVID-19 ; COVID-19 Testing ; COVID-19 Vaccines ; China ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Critical Illness ; Humans ; Hungary ; Pandemics ; Pneumonia, Viral/diagnosis ; Prognosis ; Real-Time Polymerase Chain Reaction ; Risk Assessment ; SARS-CoV-2
Chemical Substances	COVID-19 Vaccines ; Covid-19 aAPC vaccine
Keywords	covid19
Language	Hungarian
Publishing date	2020-04-01
Publishing country	Hungary
Document type	Journal Article ; Review
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2020.31815
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