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Electrical Impedance Tomography-Based Dynamic Ventilation-Perfusion Functional Phenotype Trajectory in Acute Respiratory Distress Syndrome: A Prospective Observational Study
Sponsor: Ruijin Hospital
Summary
Acute Respiratory Distress Syndrome (ARDS) is characterized by severe hypoxemia and extensive lung injury. Recent studies indicate that lung functional phenotypes - particularly the distribution and evolution of lung perfusion - may be closely related to patient outcomes. Electrical impedance tomography (EIT) offers non-invasive, bedside, real-time monitoring of lung perfusion patterns and enables classification into distinct phenotypes and trajectory types over the course of illness. To date, limited data exist on perfusion phenotype trajectories in ARDS patients and their relationship with clinical outcomes. This study seeks to characterize dynamic lung dynamic ventilation-perfusion functional Phenotype using EIT and explore their prognostic significance. Objectives Primary Objective: To identify lung perfusion phenotype trajectories in ARDS patients using EIT and assess their association with 28-day mortality. Secondary Objectives: * To determine the relationship between different trajectory types and improvements in oxygenation and respiratory mechanics. * To investigate how ventilator settings (PEEP, driving pressure) interact with perfusion changes. * To support individualized mechanical ventilation strategies based on Ventilation-Perfusion Functional Phenotype monitoring
Key Details
Gender
All
Age Range
18 Years - 90 Years
Study Type
OBSERVATIONAL
Enrollment
120
Start Date
2025-01-01
Completion Date
2027-01-01
Last Updated
2026-01-27
Healthy Volunteers
No
Conditions
Interventions
EIT Monitoring
* 16-electrode belt positioned around the thorax * Daily perfusion assessment (10 min recording) at baseline and after major clinical interventions (e.g., PEEP change, position change) * Pulmonary perfusion analysis will primarily be based on the pulse-synchronous impedance signal derived from EIT during brief respiratory pauses, estimating regional perfusion from cardiac-related impedance changes. When signal quality is insufficient, or in cases of significant arrhythmia or other conditions affecting pulse signal detection, the saline indicator method will be applied for validation or calibration. * This involves rapid intravenous bolus injection of 10-20 mL room-temperature saline, using the induced transient conductivity change as a perfusion marker:Ventilation-Perfusion Functional Phenotype will be derived by combining EIT-based tidal and pulsatile impedance changes, calculating the regional V/Q ratio.
Locations (1)
Department of Critical Care Medicine，Ruijin Hospital，Shanghai Jiao Tong University School of Medicine
Shanghai, Shanghai Municipality, China