Evidence map›Paper›PMID 39773268›Full record

ArticleCritical care (London, England)2025

Ventilation distribution during spontaneous breathing trials predicts liberation from mechanical ventilation: the VISION study.

Vorakamol Phoophiboon, Antenor Rodrigues, Fernando Vieira, Matthew Ko, Fabiana Madotto, Annia Schreiber, Nannan Sun, Mayson L A Sousa, Mattia Docci, Clement Brault and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Vorakamol PhoophiboonUnity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.
Antenor RodriguesUnity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.
Fernando VieiraUnity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.
Matthew KoUnity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.
Fabiana MadottoDepartment of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Annia SchreiberUnity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.
Nannan SunUnity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.
Mayson L A SousaUnity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.
Mattia DocciUnity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.
Clement BraultUnity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.
Luca S MengaUnity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.
Irene TeliasUnity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.
Thomas PirainoDepartment of Anesthesia, McMaster University, Hamilton, ON, Canada.
Ewan C GoligherInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Laurent BrochardUnity Health Toronto, Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada. Laurent.brochard@unityhealth.to.

Funding

Physicians' Services Incorporated Foundation 23-26
6 · The paper itself

Abstract

backgroundPredicting complete liberation from mechanical ventilation (MV) is still challenging. Electrical impedance tomography (EIT) offers a non-invasive measure of regional ventilation distribution and could bring additional information. RESEARCH QUESTION: Whether the display of regional ventilation distribution during a Spontaneous Breathing Trial (SBT) could help at predicting early and successful liberation from MV. STUDY DESIGN AND

methodsPatients were monitored with EIT during the SBT. The tidal image was divided into ventral and dorsal regions and displayed simultaneously. We explored the ventral-to-dorsal ventilation difference in percentage, and its association with clinical outcomes. Liberation success was defined pragmatically as passing SBT followed by extubation within 24 h without reintubation for 7 days. Failure included use of rescue therapy, reintubation within 7 days, tracheostomy, and not being extubated within 24 h after succesful SBT. A training cohort was used for discovery, followed by a validation cohort.

resultsAmong a total of 98 patients analyzed, 85 passed SBT (87%), but rapid liberation success occurred only in 40; 13.5% of extubated patients required reintubation. From the first minutes to the entire SBT duration, the absolute ventral-to-dorsal difference was consistently smaller in liberation success compared to all subgroups of failure (p < 0.0001). An absolute difference at 5 min of SBT > 20% was associated with failure of liberation, with sensitivity and specificity of 71% and 78% and positive predictive value 81% in a validation cohort.

conclusionDuring SBT, a large ventral-to-dorsal difference in ventilation indicated by EIT may help to rapidly identify patients at risk of liberation failure.

Indexed as

Electric ImpedanceRespiration, ArtificialVentilator WeaningAgedCohort StudiesFemaleHumansMaleMiddle AgedPredictive Value of TestsProspective StudiesRespirationTomographyElectrical impedance tomographyVentilation-distributionWeaning

Identifiers

PMID39773268
PMCPMC11705700

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.