Real-Time Monitoring of Lung Injury in a Porcine Model Using Electrical Impedance Tomography: Correlation Between Early Quantitative Assessment and AIS Grading

Real-Time Monitoring of Lung Injury in a Porcine Model Using Electrical Impedance Tomography: Correlation Between Early Quantitative Assessment and AIS Grading | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Real-Time Monitoring of Lung Injury in a Porcine Model Using Electrical Impedance Tomography: Correlation Between Early Quantitative Assessment and AIS Grading Junyao Li, Zengkai Shi, Yangming Liu, Zuyu Che, Yu Wang, Huizhe Wang, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9496758/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background: Lung injuries are a prevalent and potentially fatal conditionin clinical emergency settings and on the battlefield, accounting for 30% to 40% of emergency department cases involving chest trauma. However, current diagnostic methods are inadequate for the urgent need for rapid triage. This study aimed to use electrical impedance tomography (EIT) technology to reflect pathophysiological changes from dynamic variations in lung impedance, thereby establishing a new method for the early assessment of lung injury. Methods: The study on anaesthetised Changbai pigs established lung injury models (projectile impact, n = 24) at varying velocities. An intergroup analysis with a pre-post design was employed. Prior to and following injury, EIT technology monitored ventilation and perfusion impedance signals. The ventilation uneven index ( VUI ), perfusion uneven index ( PUI ), and ventilation/perfusion ( V/Q ) ratio were extracted from the EIT images to analyse their relationship with impact velocity and their correlation with AIS grading. Results: EIT imaging revealed a positive correlation between the degree of pulmonary ventilation and perfusion deficit and the impact velocity. Statistical analysis indicated that EIT indices exhibited a progressive increase in conjunction with rising impact velocity. Post-injury V/Q demonstrated a significant decrease, while VUI and PUI exhibited significant increases (all P < 0.01). The implementation of correlation analysis yielded a significant correlation between ΔV/Q and AIS grading ( r = 0.87, P < 0.001). ΔV/Q exhibited the highest diagnostic accuracy for identifying severe lung injury ( AUC = 0.96, P < 0.001), while ΔVUI ( AUC = 0.85, P < 0.01) and ΔPUI ( AUC = 0.79, P < 0.05) also demonstrated adequate diagnostic performance. Conclusion: EIT can quantify the severity of lung injury, enabling gradient-based classification. It provides a functional basis for early non-invasive triage and holds significant clinical value. electrical impedance tomography lung injury pulmonary ventilation pulmonary perfusion abbreviated injury scale Full Text Additional Declarations No competing interests reported. Supplementary Files Additionalfile1.pdf Additionalfile2.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 05 May, 2026 Reviewers agreed at journal 30 Apr, 2026 Reviewers agreed at journal 29 Apr, 2026 Reviewers invited by journal 29 Apr, 2026 Editor assigned by journal 24 Apr, 2026 Submission checks completed at journal 23 Apr, 2026 First submitted to journal 22 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9496758","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":634620280,"identity":"f461e131-751a-40c0-9231-a9b260b686d4","order_by":0,"name":"Junyao Li","email":"","orcid":"","institution":"Shaanxi Provincial key Laboratory of Bioelectromagnetic Detection and Intelligent Perception, Department of Biomedical Engineering, Air Force Medical University, Xi’an, 710032, 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Grading","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"respiratory-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"rere","sideBox":"Learn more about [Respiratory Research](http://respiratory-research.biomedcentral.com/)","snPcode":"12931","submissionUrl":"https://submission.nature.com/new-submission/12931/3","title":"Respiratory Research","twitterHandle":"@RespiratoryBMC","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"electrical impedance tomography, lung injury, pulmonary ventilation, pulmonary perfusion, abbreviated injury scale","lastPublishedDoi":"10.21203/rs.3.rs-9496758/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9496758/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Lung injuries are a prevalent and potentially fatal conditionin clinical emergency settings and on the battlefield, accounting for 30% to 40% of emergency department cases involving chest trauma. However, current diagnostic methods are inadequate for the urgent need for rapid triage. This study aimed to use electrical impedance tomography (EIT) technology to reflect pathophysiological changes from dynamic variations in lung impedance, thereby establishing a new method for the early assessment of lung injury.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThe study on anaesthetised Changbai pigs established lung injury models (projectile impact, \u003cem\u003en \u003c/em\u003e= 24) at varying velocities. An intergroup analysis with a pre-post design was employed. Prior to and following injury, EIT technology monitored ventilation and perfusion impedance signals. The ventilation uneven index (\u003cem\u003eVUI\u003c/em\u003e), perfusion uneven index (\u003cem\u003ePUI\u003c/em\u003e), and ventilation/perfusion (\u003cem\u003eV/Q\u003c/em\u003e) ratio were extracted from the EIT images to analyse their relationship with impact velocity and their correlation with AIS grading.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eEIT imaging revealed a positive correlation between the degree of pulmonary ventilation and perfusion deficit and the impact velocity. Statistical analysis indicated that EIT indices exhibited a progressive increase in conjunction with rising impact velocity. Post-injury \u003cem\u003eV/Q\u003c/em\u003e demonstrated a significant decrease, while \u003cem\u003eVUI\u003c/em\u003eand \u003cem\u003ePUI\u003c/em\u003e exhibited significant increases (all \u003cem\u003eP \u003c/em\u003e\u0026lt; 0.01). The implementation of correlation analysis yielded a significant correlation between \u003cem\u003eΔV/Q\u003c/em\u003e and AIS grading (\u003cem\u003er \u003c/em\u003e= 0.87, \u003cem\u003eP \u003c/em\u003e\u0026lt; 0.001). \u003cem\u003eΔV/Q\u003c/em\u003e exhibited the highest diagnostic accuracy for identifying severe lung injury (\u003cem\u003eAUC \u003c/em\u003e= 0.96, \u003cem\u003eP \u003c/em\u003e\u0026lt; 0.001), while \u003cem\u003eΔVUI\u003c/em\u003e (\u003cem\u003eAUC \u003c/em\u003e= 0.85, \u003cem\u003eP \u003c/em\u003e\u0026lt; 0.01) and \u003cem\u003eΔPUI\u003c/em\u003e (\u003cem\u003eAUC \u003c/em\u003e= 0.79, \u003cem\u003eP \u003c/em\u003e\u0026lt; 0.05) also demonstrated adequate diagnostic performance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eEIT can quantify the severity of lung injury, enabling gradient-based classification. It provides a functional basis for early non-invasive triage and holds significant clinical value.\u003c/p\u003e","manuscriptTitle":"Real-Time Monitoring of Lung Injury in a Porcine Model Using Electrical Impedance Tomography: Correlation Between Early Quantitative Assessment and AIS Grading","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-08 15:30:18","doi":"10.21203/rs.3.rs-9496758/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"75756901933463226369600767067797977943","date":"2026-05-05T08:06:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"177753767470349501990182245472859675164","date":"2026-04-30T13:41:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"122313541587865726292758246221653259325","date":"2026-04-29T23:37:42+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-29T17:51:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-24T15:10:39+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-23T13:08:32+00:00","index":"","fulltext":""},{"type":"submitted","content":"Respiratory Research","date":"2026-04-22T12:57:23+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"respiratory-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"rere","sideBox":"Learn more about [Respiratory Research](http://respiratory-research.biomedcentral.com/)","snPcode":"12931","submissionUrl":"https://submission.nature.com/new-submission/12931/3","title":"Respiratory Research","twitterHandle":"@RespiratoryBMC","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ed796081-ecc7-47a9-aeeb-c72c9805e0d3","owner":[],"postedDate":"May 8th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"75756901933463226369600767067797977943","date":"2026-05-05T08:06:33+00:00","index":54,"fulltext":""},{"type":"reviewerAgreed","content":"177753767470349501990182245472859675164","date":"2026-04-30T13:41:43+00:00","index":45,"fulltext":""},{"type":"reviewerAgreed","content":"122313541587865726292758246221653259325","date":"2026-04-29T23:37:42+00:00","index":42,"fulltext":""},{"type":"reviewersInvited","content":"31","date":"2026-04-29T17:51:00+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-08T15:30:19+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-08 15:30:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9496758","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9496758","identity":"rs-9496758","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}