ArticleAnnals of intensive care2025
Association between ventilation-perfusion matching improvement during initial prone positioning and ICU mortality in patients with moderate to severe ARDS: a prospective two-center study.
Article in Annals of intensive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Improvement of Acute Respiratory Distress Syndrome Ventilation-perfusion Matching by Prone Positioning Assessed by Electrical Impedance Tomography
A Randomized Controlled Trial of Early EIT-Guided PEEP Titration on Pulmonary Physiology in Moderate-to-Severe ARDS Patients Undergoing Prone Positioning
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Definition and prognostic value of response to prone positioning in ARDS: a systematic review and meta-analysis.Critical care (London, England) · 2026Pooled it
- Safety and Feasibility of Bedside Electrical Impedance Tomography With Hypertonic Saline Contrast for Assessing Pulmonary Perfusion in Mechanically Ventilated Children With Acute Respiratory Distress Syndrome: A Pilot Study.Critical care explorations · 2026Observational
- Right ventricular-protective ventilation in acute respiratory distress syndrome: phenotypes, monitoring and ventilatory management.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- Clinical Application of Electrical Impedance Tomography in Emergency and Critical Care Medicine.Journal of clinical medicine · 2026Review
- Effects of two ventilator-weaning methods on lung volume and ventilation distribution by electrical impedance tomography in post-cardiac surgery patients: a prospective cohort study.Journal of intensive care · 2026Article
- Shunt: pathophysiological mechanisms and clinical implications of ineffective circulating volume.Frontiers in physiology · 2026Review
- Refining thresholds and timing in V/Q matching assessment during prone positioning in ARDS.Annals of intensive care · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
backgroundProne positioning (PP) is widely used in patients with moderate to severe acute respiratory distress syndrome (ARDS) to reduce mortality by mitigating the risk of ventilation-induced lung injury (VILI) and enhancing ventilation-perfusion (V/Q) matching. However, patient responses to PP are variable, and the relationship between V/Q matching improvement during PP and clinical outcomes remains unclear. This study aimed to test the hypothesis that improvements in V/Q matching 4 h within the first PP are associated with reduced intensive care unit (ICU) mortality.
methodsIn this two-center, prospective, observational study, regional ventilation and perfusion changes in patients with moderate to severe ARDS were evaluated using electrical impedance tomography (EIT) during the first PP session. Patients were categorized as responders or non-responders based on whether V/Q matching improved by ≥ 10% within 4 h of the first PP. The primary endpoint was ICU mortality, and the secondary endpoint was ventilator-free days at day 28.
resultsA total of 77 patients were included in the study, with 46 (59.7%) classified as responders and 31 (40.3%) as non-responders. EIT revealed significant improvements in V/Q matching during PP, primarily through reduced dorsal shunt and ventral dead space. These improvements were partially sustained after resupination. Responders showed significantly lower ICU mortality (28.3% vs. 51.6%; P = 0.038) and more ventilator-free days at day 28 (16 [range, 0-21] days vs. 9 [0-15] days; P = 0.024) than non-responders. Multivariate analysis confirmed enhanced V/Q matching as an independent protective factor against mortality (OR, 0.790; 95% CI, 0.681-0.917; P = 0.002).
conclusionsImprovement in V/Q matching 4 h within the first PP is associated with lower ICU mortality in patients with moderate to severe ARDS. These findings underscore the importance of PP in ARDS management and highlight the potential of V/Q responsiveness in guiding individualized PP strategies.
trial registrationClinicalTrials.Gov: NCT05765760. Registered 28 February 2023.
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Registered trials
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.