CoRLEIT, Covid Regional Lung EIT

A key challenge for the COVID-19 pandemic is the requirement to monitor for deterioration and provide timely escalation interventions to an unprecedented number of patients at risk of respiratory failure. Existing monitoring poorly predicts sudden deterioration in COVID-19 pneumonia. Regional information, currently from CT scans, has been informative (Scudellari, 2020) [1], but does not provide dynamic information. There is an urgent need for a low cost, bedside, non-invasive imaging system, to continuously monitor dynamic changes in regional lung ventilation [2][3][4][5]. Electrical Impedance Tomography (EIT) can provide this and has proved useful in managing acute respiratory syndrome in infants and adults (Bachmann et al 2018) [2]. We have already developed a low cost wearable EIT system for neonates (CRADL; http://cradlproject.org/) and obtained clinical results from 200 subjects, each for up to 72 hours of continuous monitoring of temporal lung volume changes. This technology can be repurposed for COVID-19 patients (Appendix) with the aim of providing novel insights into COVID-19 pathophysiology, and with the potential to provide a solution for respiratory failure monitoring at scale. Using EIT in HDU-pre-ICU patients, evaluating and stratifying treatment response (to prone positioning, CPAP, other breathing support) and then following through into ICU with ventilation interventions if they deteriorate, will add invaluable information about how COVID-19 effects the respiratory system. This will establish the merits of EIT monitoring for COVID-19 respiratory failure, in particular enhance and expedite clinical research into optimal COVID-19 breathing support treatment strategy and facilitate development of EIT guided personalised treatment plans.