Real-time functional monitoring with electrical impedance tomography during bronchoscopic and thoracoscopic interventions

Traditional monitoring during interventional pulmonary procedures such as bronchoscopy and thoracoscopy offers limited real-time functional insights. This case series explores the feasibility and utility of real-time Electrical Impedance Tomography (EIT) for functional lung monitoring during these interventions. A total of eight patients undergoing tumor ablation, airway stent placement, or thoracoscopic adhesion release were monitored using a 16-electrode EIT belt positioned at the 5th intercostal space. Ventilation patterns, global ventilation, regional ventilation distribution, and symmetry were recorded before, during, and after each intervention. EIT quantified immediate functional changes associated with procedural steps. Following bronchoscopic tumor ablation, global ventilation increased from 218.09 to 327.07 in one patient and from 90.99 to 232.92 in another, with marked regional improvement in the treated lung (e.g., ROI 1: 1.31→124.39 and 7.90→90.21). it also well mirrored ventilation and perfusion changes resulted from procedural complications. During airway stent placement, EIT detected a transient reduction in left lung ventilation during bleeding and suctioning, followed by recovery after hemostasis. In patients with chronic airway obstruction, EIT demonstrated only modest immediate improvement despite successful bronchoscopic airway reopening, suggesting delayed functional re-expansion. During thoracoscopic adhesiolysis, EIT visualized regional re-ventilation while identifying areas of persistent ventilation impairment related to pleural disease. In this case series, EIT enabled distinguishing between immediate structural and physiological outcomes and immediate detection of complications, by capturing dynamic ventilation changes. EIT served as an important complement to traditional imaging and endoscopic methods in our patients.