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Electrical impedance tomography (EIT) noninvasively creates images of the local ventilation and arguably lung perfusion distribution at bedside. Methodological and clinical aspects of EIT when used as a monitoring tool in the intensive care unit are reviewed and discussed.Whereas former investigations addressed the issue of validating EIT to measure regional ventilation, current studies focus on clinical applications such as detection of pneumothorax. Furthermore, EIT has been used to quantify lung collapse and tidal recruitment in order to titrate positive end-expiratory pressure. Indicator-free EIT measurements might be sufficient for the continuous measurement of cardiac stroke volume, but assessment of regional lung perfusion presumably requires the use of a contrast agent such as hypertonic saline.Growing evidence suggests that EIT may play an important role in individually optimizing ventilator settings in critically ill patients.