Predicting early prone position ventilation responsiveness in patients with acute respiratory distress syndrome based on electrical impedance tomography: a prospective study.
Total: 64.0Innovation: 7Impact: 5Rigor: 7Citation: 5
Summary
In 94 adults with moderate-to-severe ARDS, 83% responded to prone positioning. Pre-prone EIT-derived dorsal shunt percentage (ROI 3) and higher respiratory system compliance differentiated responders, enabling early prediction of PPV benefit.
Key Findings
- Among 94 ARDS patients, 78 (83%) were PPV responders and 16 (17%) were nonresponders.
- Higher pre-prone dorsal (ROI 3) shunt percentage measured by EIT predicted PPV responsiveness.
- Responders exhibited higher respiratory system compliance than nonresponders.
Clinical Implications
Use baseline EIT to estimate dorsal shunt percentage before proning; patients with higher pre-prone dorsal shunt and better compliance are more likely to benefit from PPV, aiding selection and timing.
Why It Matters
Provides a bedside, physiology-based predictor of prone responsiveness using EIT, supporting precision ventilation and reducing unnecessary PPV exposure.
Limitations
- Single-center study limiting generalizability
- Incomplete reporting of some numerical thresholds and potential confounders
Future Directions
Validate EIT-based shunt metrics and thresholds in multicenter cohorts and test EIT-guided proning strategies in randomized trials.
Study Information
- Study Type
- Cohort
- Research Domain
- Diagnosis
- Evidence Level
- III - Single-center prospective observational cohort assessing physiological predictors of prone response
- Study Design
- OTHER