ArticleCritical care (London, England)2026
Effect of prone positioning on pathophysiology and lung histopathology during VV-ECMO in severe ARDS: an experimental animal study.
Article in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
- Pulmonary vascular dysfunction in ARDS Pathophysiology and therapeutic implications.Annals of intensive care · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
29 authors.
Funding
Abstract
backgroundProne positioning improves survival in patients with acute respiratory distress syndrome (ARDS) by reducing ventilator-induced lung injury and enhancing ventilation-perfusion matching. Whether these physiological benefits translate to patients supported with veno-venous extracorporeal membrane oxygenation (VV-ECMO) remains uncertain.
methodsThis study compared the effects of prone versus supine positioning on the wet-to-dry lung weight ratio, gas exchange, respiratory mechanics, electrical impedance tomography, histopathology, microbiology, hemodynamics, and extracorporeal circuit function in pigs with severe ARDS undergoing VV-ECMO. Pigs with severe ARDS were placed on VV-ECMO according to EOLIA criteria and then randomized to either prone or supine positioning for 48 h, while receiving an ultraprotective ventilation strategy. Futility analyses were performed at half of the planned sample size using conditional power calculations, with early termination criteria set at < 10% probability of achieving statistical significance.
resultsEight pigs with severe ARDS were randomized after VV-ECMO initiation. Prone positioning, compared with the supine position, resulted in a similar wet-to-dry lung weight ratio (6.77 [6.13-8.17] vs. 6.70 [6.22-8.48]; p = 0.89), meeting the futility threshold. Compared with the supine position, prone positioning significantly reduced the proportion of ventilation in non-dependent lung regions (51 [47-61.25]% vs. 86 [68.50-90]%; p = 0.02), thereby indicating a redistribution of ventilation toward dependent areas. Consistent with this shift in ventilation distribution, prone positioning redistributed histopathological lung injury, with relative preservation of non-dependent regions and greater damage in dependent zones, but without a net global decrease. Shunt fraction approached 100% in both groups, with no significant differences. Pulmonary CO₂ elimination was 8.45 (1.45-26.13) mL/min in the prone group and 0 (0-0.70) mL/min in the supine group (p = 0.23). Lung compliance showed no intergroup differences (14.67 [12.75-19.91] vs. 16.68 [15.51-19.47] mL/cmH₂O; p = 0.88), with similarly elevated end-inspiratory transpulmonary pressures. No significant differences were observed in systemic or pulmonary hemodynamics, nor in VV-ECMO circuit function.
conclusionsProne positioning did not decrease the overall severity of lung injury. Rather, it shifted the distribution of damage, with greater involvement of dependent regions and relative preservation of non-dependent areas.
Indexed as
Identifiers
What OpenQuestion holds
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.