Fig. 1

A Effect of prone position on ventilation, perfusion and ventilation–perfusion (V/Q) matching in a patient under VV ECMO therapy. First row, supine position. Second row, prone position. First column, functional EIT image showing tidal ventilation distribution. Highly ventilated regions are marked in light blue to white. Distribution percentages are listed in the corresponding regions of interest (quadrants). Second column, functional EIT image showing perfusion distribution. Highly perfused regions are marked in red. Third column, functional EIT image showing the distribution of regional ventilation–perfusion matching. Ventilated regions were defined as pixels with impedance changes higher than 20% of the maximum tidal impedance variation in the functional ventilation image. Perfused regions were defined as pixels higher than 20% of the maximum bolus-related impedance change in the functional perfusion image. Regions with high ventilation and low perfusion are marked in gray (denoted as dead space), low ventilation and high-perfusion regions in red (denoted as shunt), and good ventilation–perfusion matching in yellow (denoted as V/Q match). From supine to prone position, dead space decreased from 17.1 to 0.0%, shunt changed from 28.6 to 25.1%, and V/Q match increased from 54.3 to 74.9%. B Effect of thrombolysis on regional perfusion and V/Q in V-A ECMO therapy. Third row, before thrombolysis. Fourth row, after thrombolysis. After thrombolysis, dead space decreased from 36.4 to 8.5%, shunt changed from 27.4 to 28.7%, and V/Q match increased from 36.2 to 62.8%