{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T07:00:01Z","timestamp":1790319601526,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Septic shock complicated by acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) presents a fundamental therapeutic conflict: shock demands aggressive fluid resuscitation, whereas lung protection requires fluid restriction and a negative fluid balance. We report the precision nursing management of a 79\u2010year\u2010old patient with septic shock, ARDS and MODS who received invasive mechanical ventilation and continuous renal replacement therapy (CRRT). A closed\u2010loop \u2018monitoring\u2013decision\u2013intervention\u2019 strategy was built around electrical impedance tomography (EIT): EIT\u2010guided positive end\u2010expiratory pressure (PEEP) titration optimised respiratory support; during CRRT fluid management, continuous EIT monitoring of ventilation distribution provided early safety warnings regarding lung ventilation; EIT\u2010based position titration established the 45\u00b0 left lateral decubitus as the optimal ventilation position; real\u2010time EIT imaging localised airway secretions to guide targeted postural drainage; and a prevention protocol for EIT electrode belt\u2013related pressure injuries was implemented. After 10\u2009days of intervention, the PaO\n                    <jats:sub>2<\/jats:sub>\n                    \/FiO\n                    <jats:sub>2<\/jats:sub>\n                    ratio increased from 150 to 356\u2009mmHg, and the patient was successfully weaned and extubated. This case suggests that EIT\u2010guided precision nursing may help balance fluid management with lung protection and provide visual guidance for airway clearance and position management; its effectiveness warrants validation in prospective studies. This case provides a reproducible, nurse\u2010led framework that integrates EIT ventilation monitoring to reconcile competing treatment goals in septic shock complicated by ARDS, offering a practical reference for complex critical care nursing.\n                  <\/jats:p>","DOI":"10.1111\/nicc.70699","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:19:40Z","timestamp":1790317180000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Electrical Impedance Tomography\u2010Guided Precision Nursing in an Older Patient With Septic Shock and\n                    <scp>ARDS<\/scp>\n                    : A Case Report"],"prefix":"10.1111","volume":"31","author":[{"given":"Susu","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine Zhejiang Hospital  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5796-5987","authenticated-orcid":false,"given":"Wenchao","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Zhejiang Hospital  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaping","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Zhejiang Hospital  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Zhejiang Hospital  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyang","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Zhejiang Hospital  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0944-9801","authenticated-orcid":false,"given":"Zhiheng","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Zhejiang Hospital  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"issue":"8","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1001\/jama.2016.0291","article-title":"Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries","volume":"315","author":"Bellani G.","year":"2016","journal-title":"Journal of the American Medical Association"},{"issue":"1","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1186\/s13613-020-00679-3","article-title":"Intravenous Fluid Therapy in the Perioperative and Critical Care Setting: Executive Summary of the International Fluid Academy (IFA)","volume":"10","author":"Malbrain M. L. N. G.","year":"2020","journal-title":"Annals of Intensive Care"},{"issue":"3","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"177","DOI":"10.14740\/jocmr6464","article-title":"Restrictive Versus Liberal Fluid Strategy for Initial Resuscitation in Sepsis and Septic Shock: A Systematic Review and Meta\u2010Analysis","volume":"18","author":"Ali A. O.","year":"2026","journal-title":"Journal of Clinical Medical Research"},{"issue":"5","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.3390\/tomography9050150","article-title":"Clinical Applicability of Electrical Impedance Tomography in Patient\u2010Tailored Ventilation: A Narrative Review","volume":"9","author":"Heines S. J. 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