{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:17:31Z","timestamp":1792513051461,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":316,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Respiratory mechanics and gas exchange parameters are readily accessible indicators for evaluating ventilation in patients with acute respiratory distress syndrome (ARDS). Computed tomography (CT) is a widely used radiological imaging technique, while electrical impedance tomography (EIT) is a novel technique for pulmonary function monitoring developed in recent years. Studies suggest that EIT combined with quantitative CT holds unique value in assessing ventilation\/perfusion (V\/Q) function. Unlike classic ARDS, the pathophysiologic alterations in ARDS following lung transplantation are complex, and the specific mechanisms remain unclear. This study aims to explore the use of respiratory mechanics, gas exchange parameters, EIT, and quantitative CT for the multimodal assessment of V\/Q function in post\u2010lung transplantation ARDS. We further aim to integrate visualizing dynamic imaging and regional quantitative lung analysis into this multimodal assessment system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We retrospectively enrolled lung transplant recipients admitted to the intensive care unit who met the Berlin criteria for ARDS. Inclusion required an arterial partial pressure of oxygen to fraction of inspired oxygen ratio (P\/F)\u2009\u2264\u2009300\u2009mmHg, with both EIT monitoring of V\/Q and high\u2010resolution CT performed within 24\u2009h of documented P\/F\u2009\u2264\u2009300\u2009mmHg. Patient baseline characteristics, respiratory mechanics parameters, gas exchange parameters, EIT data, and CT images were collected. Subjects were stratified into two groups according to P\/F values: a low P\/F group (P\/F\u2009&lt;\u2009200\u2009mmHg) and a high P\/F group (200\u2009mmHg\u2009\u2264\u2009P\/F\u2009\u2264\u2009300\u2009mmHg). Ventilation parameters derived from EIT included global inhomogeneity index (GI), center of ventilation (COV), and regional ventilation delay index (RVDI). Using hypertonic saline contrast\u2010enhanced EIT, we acquired V\/Q parameters and calculated both global and regional EIT\u2010based dead space fraction (EIT\u2010Dead Space), intrapulmonary shunt fraction (EIT\u2010Shunt), and V\/Q matching (EIT\u2010V\/Q Match). Chest CT images were processed through a multitask learning U\u2010net\u2010based computer\u2010aided diagnostic model. This enabled semiautomated lung segmentation, identification of high\u2010density lesions, quantitative analysis, and three\u2010dimensional visualization. Pulmonary volumes, lesion volumes, and percentage lesion volumes (calculated as lung lesion volume divided by lung volume) were, respectively, quantified for the left and right lungs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>The study ultimately enrolled 21 lung transplant recipients with ARDS, comprising five patients in the low P\/F group and 16 in the high P\/F group. Among 21 patients, the low P\/F group demonstrated significantly higher ventilation ratio (VR), RVDI, and EIT\u2010Dead Space, along with lower EIT\u2010V\/Q match levels compared to the high P\/F group, while no significant difference in EIT\u2010Shunt was observed between the two groups. EIT\u2010Dead Space showed substantial agreement with ventilator\u2010measured dead space fraction, and VR exhibited a significant positive correlation with EIT\u2010Dead Space. In the two groups, quantitative CT\u2010derived pulmonary metrics\u2014including lung volume, lesion volume, and percentage lesion volume\u2014showed no significant differences between the low and high P\/F groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among lung transplant recipients with ARDS, the low P\/F group demonstrated elevated VR, RVDI, and EIT\u2010Dead Space, alongside reduced EIT\u2010V\/Q matching levels when compared to the high P\/F group. Notably, no significant differences were found in the quantitative CT\u2010derived lesion volume parameters between the two groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/crj.70135","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T09:27:48Z","timestamp":1763026068000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["EIT Outperforms Quantitative CT in Stratifying ARDS Severity After Lung Transplantation: A Retrospective Study"],"prefix":"10.1111","volume":"19","author":[{"given":"Hui","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine The First Affiliated Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hu","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine The First Affiliated Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Shandong University Affiliated Clinical Center for Public Health  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine and War Trauma Emergency Center The 903rd Hospital of the Joint Logistics Support Force  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruoruo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine and War Trauma Emergency Center The 903rd Hospital of the Joint Logistics Support Force  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine The First Affiliated Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9020-7886","authenticated-orcid":false,"given":"Xia","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine The First Affiliated Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0291"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(14)70097-9"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00439-6"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01439-8"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-021-03615-4"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12041563"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1410639"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1148\/ryct.2021190252"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.08.001"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2021.07.021"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.07.021"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201804-0692OC"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202002-0373LE"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04338-4"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2017.12.06"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0b013e3283390cbf"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2016-208357"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-021-00921-6"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005450"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202101-0229IM"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.12.033"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-06801-0"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2020190099"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04315-x"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202005-1780LE"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2021.3072956"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-022-00634-x"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-020-00450-1"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc3827"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012835"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00137614"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep054"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-019-0601-0"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8081176"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.2478\/joeb-2021-0007"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181958d2f"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201405-0812IM"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-024-04865-8"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.986422"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13665-015-0114-8"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201403-104ED"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2021.106555"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.29778"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.150.2.8049839"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12194-024-00853-3"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2010.10.017"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/MNM.0000000000001021"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.70103"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202504-0873IM"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/2471207"}],"container-title":["The Clinical Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/crj.70135","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T04:31:36Z","timestamp":1764563496000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/crj.70135"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":50,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/crj.70135"],"URL":"https:\/\/doi.org\/10.1111\/crj.70135","archive":["Portico"],"relation":{},"ISSN":["1752-6981","1752-699X"],"issn-type":[{"value":"1752-6981","type":"print"},{"value":"1752-699X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-07-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70135"}}