Respiratory failure & ventilation
Predicting early prone position ventilation responsiveness in patients with acute respiratory distress syndrome based on electrical impedance tomography: a prospective study
Authors' conclusion
For moderate to severe ARDS patients, the shunt% in ROI 3 before PPV could help to predict the response of PPV during the early phase.
Study context
- Population
- Adults with moderate-to-severe acute respiratory distress syndrome (ARDS) (Berlin, PaO2/FiO2 < 150mmHg) undergoing protocolized PPV within 48 h post-intubation
- Participants
- 94 adults
- Exposure
- PPV responders vs nonresponders
- Respondersn = 78
- Nonrespondersn = 16reference
- Outcome
- Predictors of response to PPV (EIT and clinical variables before PPV)
- Follow-up
- Before PPV and PPV 16 h
Methodological detailssingle-center
- Single-center
Main finding
As reported in the abstract
Shunt% in ROI 3 before PPV as predictor of response to PPV · before PPV
Shunt% in ROI 3Odds ratio (95% CI)P value
Multivariate logistic regression; independent predictor
1.190(1.055–1.342)
P = 0.005- Cut-off less than 8.4%: sensitivity 94%, specificity 76%
- AUC 0.89 (95% CI 0.82–0.95); P < 0.001
Observational data: associations, not effects.
Further findings
Crs before PPV
P = 0.037
Median
| Outcome | Responders | Nonresponders | P value |
|---|---|---|---|
| COV index before PPV | 45.1 (IQR 41.7–48.1) | 40.5 (IQR 38.0–45.7) | P = 0.035 |
| V/Q mismatch% in ROI 3 before PPV | 9.6% (IQR 6.6%–13.7%) | 16.5% (IQR 12.8%–20.5%) | P < 0.001 |
Shunt% in ROI 3 combined with Crs before PPV (diagnostic system)
- AUC
- 0.92
- Sensitivity
- 0.94
- Specificity
- 0.89
Original publication
Predicting early prone position ventilation responsiveness in patients with acute respiratory distress syndrome based on electrical impedance tomography: a prospective study. Crit Care. Published 4 December 2025. doi:10.
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