Ventilation-Perfusion Matching in Early-stage Prone Position Ventilation

Chinese Academy of Medical Sciences & Peking Union Medical College

Status: Completed

Conditions: Acute Respiratory Distress Syndrome

Study type: Observational

Funder types: Other

Identifiers

NCT05816928

EIT20230403

Details and patient eligibility

About

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).

Full description

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.

Enrollment: 29 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Above the age of 18
• Diagnosed with ARDS based on the Berlin Definition of ARDS
• Under mechanical ventilation

Exclusion criteria

• Contraindications to EIT examination and prone position
• Refusal of signing the informed consent

Trial design

29 participants in 2 patient groups

COVID19-associated ARDS (CARDS)

Description:

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)

Description:

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.