Case report: Electrical impedance tomography-guided ventilator weaning in an obese patient with severe pneumonia

Background: Electrical impedance tomography (EIT) evaluates lung function by providing continuous, real-time monitoring of regional lung ventilation distribution to guide the restoration of lung ventilation. Patients with obesity who are dependent on mechanical ventilation often struggle with weaning. This case report highlights the potential of EIT to guide the weaning of ventilator-dependent patients in an obese patient with severe pneumonia.

Case summary: A 23-year-old male obese patient was admitted to Zhongshan People's Hospital in November 2023 due to progressive dyspnea. He suffered from recurrent fever and worsening oxygenation and had a 20+ year history of syringomyelia. Combined with abnormal computed tomography imaging, the discovery of a viral infection in the bronchoalveolar lavage fluid, and next-generation sequencing results, he was diagnosed with severe pneumonia. In addition to conventional treatment, EIT was used to guide him through postural changes and ventilation recovery. EIT-informed prone positioning improved ventilation distribution and facilitated successful ventilator weaning on day 26. The patient was discharged after recovering spontaneous respiratory function.

Conclusion: EIT may help ventilator-dependent obese patients achieve tailored targets to improve ventilatory outcomes.