Improved oxygenation using the prone position in patients with ARDS

Acta Anaesthesiologica Scandinavica
H FlaattenO Hevrøy

Abstract

The prone position is known to increase oxygen uptake in patients with Adult Respiratory Distress Syndrome (ARDS). In this clinical study from 1995-96, 14 ARDS patients with severe respiratory failure were treated for at least 1 h in the prone position. Responders, defined as having more than 10% increase in PaO2/FiO2 ratio from baseline after 1 h, were treated at least 6 h in the prone position. 11 patients responded during the first period of the prone position (primary responders). Two of the 3 non-responders were turned prone a second time with increase in the PaO2/FiO2 ratio (secondary responders). Mean PaO2/FiO2 ratio (mean +/- SEM) in the supine position was 11.7 +/- 0.8 kPa, increasing to 16.6 +/- 1.8 kPa and 18.0 +/- 1.4 kPa after 1 and 6 h respectively (P = 0.009). Mean time spent in the prone position was 69 h (range 3-256 h), and mean ventilatory time was 17 d (3-52 d). The mortality in this subgroup of our patients with ARDS was 42%, compared to 58% in 19 patients not turned prone in the same period. The prone position together with PEEP appears to improve ventilation-perfusion matching. The prone position is simple, effective and readily available and could be used early in most patients with ARDS.

References

Jan 1, 1976·Critical Care Medicine·M A Piehl, R S Brown
Jan 1, 1991·Acta Anaesthesiologica Scandinavica. Supplementum·L GattinoniM Tagliabue
Aug 1, 1991·Journal of Applied Physiology·R W GlennyH T Robertson
Oct 1, 1989·Journal of Applied Physiology·Q H YangS J Lai-Fook
Jul 1, 1988·Chest·M LangerL Gattinoni
Aug 1, 1986·Journal of Applied Physiology·K C Beck, K Rehder
Jul 1, 1994·American Journal of Respiratory and Critical Care Medicine·W J LammR K Albert
Jan 1, 1994·Intensive Care Medicine·R K Albert
Dec 22, 1993·JAMA : the Journal of the American Medical Association·J R Le GallF Saulnier
Jan 1, 1993·The American Review of Respiratory Disease·J F Lewis, A H Jobe
Feb 1, 1997·American Journal of Respiratory and Critical Care Medicine·G ChatteD Robert

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Citations

Apr 18, 2000·Critical Care Clinics·A M Fein, M G Calalang-Colucci
Nov 30, 2000·Journal of Advanced Nursing·A N BreiburgJ D Pierce
Dec 12, 2003·Critical Care Medicine·David A Zygun
Jan 13, 2005·Critical Care Medicine·Wolfgang OczenskiRobert D Fitzgerald
Feb 5, 2000·BMJ : British Medical Journal·S Stott
Jan 18, 2012·Critical Care Medicine·Michael J Breslow
Feb 10, 2007·Annales Françaises D'anesthèsie Et De Rèanimation·M-S MebazaaM-S Ben Ammar
Jun 7, 2003·Anaesthesia·N MalarkkanA B Lumb
Apr 14, 2006·São Paulo Medical Journal = Revista Paulista De Medicina·Heloisa Baccaro RossettiJosé Luiz Gomes do Amaral
Apr 28, 2004·European Journal of Anaesthesiology·M RadstromJ P Bengtsson
Dec 4, 2003·Intensive Care Medicine·Jason EasbyStephen Graham
Dec 18, 2013·The International Journal of Artificial Organs·Valesca KippingMaria Deja
Jul 19, 2002·Chest Surgery Clinics of North America·Tehmina Badar, Akhil Bidani

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