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Electrical impedance tomography effectively used in a case of paediatric pulmonary Langerhans cell histiocytosis
  1. Patrick Davies1,2,
  2. Simon Gates1,
  3. Richard Grundy3,4
  1. 1Paediatric Critical Care Unit, Nottingham University Hospitals NHS Trust, Nottingham Children’s Hospital, Nottingham, UK
  2. 2School of Medicine, University of Nottingham, Nottingham, UK
  3. 3Department of Haematology and Oncology, Nottingham Children’s Hospital, Nottingham, UK
  4. 4Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
  1. Correspondence to Dr Patrick Davies, patrick.davies{at}


A 2-year-old boy with severe pulmonary Langerhans cell histiocytosis presented in extreme respiratory failure. He was intubated and ventilated. Despite maximal support, he deteriorated and needed extremely high ventilator pressures. An electrical impedance tomography monitor was used to inform management. This is a monitoring technique which is not used in children due to the lack of suitable interface devices and a lack of randomised clinical evidence. Despite technical difficulties, a good signal was achieved. This informed management and enabled the selection of a suitable ventilator strategy, facilitating weaning. Electrical impedance tomography is a viable technology for use in paediatric critical respiratory failure. This is a non-invasive and safe technology which adds individual patient information which is not available through any other modalities. We urge equipment manufacturers to develop belts which will allow routine application of this life-saving technology in children.

  • paediatric intensive care
  • mechanical ventilation
  • respiratory medicine
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  • Contributors All authors wrote and edited the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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