Prone positioning improves ventilation–perfusion matching assessed by electrical impedance tomography in patients with ARDS: a prospective physiological study

Author:

Wang Yu-xian,Zhong Ming,Dong Min-hui,Song Jie-qiong,Zheng Yi-jun,Wu Wei,Tao Jia-le,Zhu Ling,Zheng Xin

Abstract

Abstract Background The physiological effects of prone ventilation in ARDS patients have been discussed for a long time but have not been fully elucidated. Electrical impedance tomography (EIT) has emerged as a tool for bedside monitoring of pulmonary ventilation and perfusion, allowing the opportunity to obtain data. This study aimed to investigate the effect of prone positioning (PP) on ventilation–perfusion matching by contrast-enhanced EIT in patients with ARDS. Design Monocenter prospective physiologic study. Setting University medical ICU. Patients Ten mechanically ventilated ARDS patients who underwent PP. Interventions We performed EIT evaluation at the initiation of PP, 3 h after PP initiation and the end of PP during the first PP session. Measurements and main results The regional distribution of ventilation and perfusion was analyzed based on EIT images and compared to the clinical variables regarding respiratory and hemodynamic status. Prolonged prone ventilation improved oxygenation in the ARDS patients. Based on EIT measurements, the distribution of ventilation was homogenized and dorsal lung ventilation was significantly improved by PP administration, while the effect of PP on lung perfusion was relatively mild, with increased dorsal lung perfusion observed. The ventilation–perfusion matched region was found to increase and correlate with the increased PaO2/FiO2 by PP, which was attributed mainly to reduced shunt in the lung. Conclusions Prolonged prone ventilation increased dorsal ventilation and perfusion, which resulted in improved ventilation–perfusion matching and oxygenation. Trial registration: ClinicalTrials.gov, NCT04725227. Registered on 25 January 2021.

Funder

National Natural Science Foundation of China

Publisher

Springer Science and Business Media LLC

Subject

Critical Care and Intensive Care Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3