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Prone positioning has been widely used in critical care medicine to improve oxygenation in patients with acute respiratory distress syndrome (ARDS). This study aimed to compare the effect of pronation on lung ventilation-perfusion matching between COVID19-associated acute respiratory distress syndrome (CARDS) and ARDS from other etiologies (non-CARDS) using electrical impedance tomography (EIT).
In this prospective study, both COVID19-associated ARDS (CARDS) patients and patients with ARDS from other etiologies (non-CARDS) were enrolled. Electrical impedance tomography (EIT) was used to evaluate the changes in ventilation and perfusion between supine and prone positions. Baseline values of the area of DeadSpace, shunt, ventilation-perfusion matching (VQmatch) were identified at the time of enrollment. Within the defined VQmatch region, the global inhomogeneity index (VQmatch-GI) was calculated to assess the degree of uniformity within the region. Prone position was applied immediately after the baseline data were collected. After 2 hours of proning, another EIT examination was conducted. Parameters such as DeadSpace, shunt, VQmatch, and other common measurements before and after pronation were taken and compared to evaluate the effect of prone positioning on CARDS and non-CARDS patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| COVID19-associated ARDS (CARDS) | This group included COVID19 patients with acute respiratory distress syndrome. Patients were put under prone position while their pulmonary function was measured using EIT before and after proning. | ||
| Non-COVID19-associated ARDS (non-CARDS) | This group included patients with acute respiratory distress syndrome from other etiologies. Patients were put under prone position while their pulmonary function was measured using EIT before and after proning. |
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| Measure | Description | Time Frame |
|---|---|---|
| DeadSpace | The area of Deadspace will be assessed using electrical impedance tomography | 3 months |
| Shunt | Shunt will be assessed using electrical impedance tomography | 3 months |
| Ventilation-perfusion matching (VQmatch) | VQmatch will be assessed using electrical impedance tomography | 3 months |
| Global inhomogeneity index (VQmatch-GI) | Within the defined VQmatch region assessed by electrical impedance tomography, the global inhomogeneity index (VQmatch-GI) was calculated to assess the degree of uniformity within the region. | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Ventilation | The ventilation of the lungs is assessed by electrical impedance tomography before and after prone positioning. | 3 months |
| Perfusion | The perfusion of the lungs is assessed by electrical impedance tomography before and after prone positioning. |
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Inclusion Criteria:
Exclusion Criteria:
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The study population includes COVID19-associated ARDS patients and ARDS patients of other etiologies in the intensive care unit.
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| Name | Affiliation | Role |
|---|---|---|
| Yun Long, MD | Peking Union Medical College | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| PUMC | Beijing | Beijing Municipality | 100730 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39793207 | Derived | Yang Y, Li H, Chi Y, Frerichs I, Zhao Z, Li Y, Zhang C, Chu H, He H, Long Y. Ventilation-perfusion matching in early-stage of prone position ventilation: a prospective cohort study between COVID-19 ARDS and ARDS from other etiologies. Physiol Meas. 2025 Jan 29;13(1). doi: 10.1088/1361-6579/ada8f1. |
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| ID | Term |
|---|---|
| D012128 | Respiratory Distress Syndrome |
| D000086382 | COVID-19 |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
| D011024 | Pneumonia, Viral |
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| 3 months |
| Center of Ventilation (CoV) | The center of ventilation of the lungs is assessed by electrical impedance tomography before and after prone positioning. | 3 months |
| Standard deviation of regional ventilation delay | The standard deviation of regional ventilation delay of the lungs is assessed by electrical impedance tomography before and after prone positioning. | 3 months |
| D011014 |
| Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D014777 | Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |