The effects of long-term prone positioning in patients with trauma-induced adult respiratory distress syndrome

Anesthesia and Analgesia
P FridrichW Mauritz

Abstract

Prone positioning improves gas exchange in some patients with adult respiratory distress syndrome (ARDS), but the effects of repeated, long-term prone positioning (20 h duration) have never been evaluated systemically. We therefore investigated 20 patients with ARDS after multiple trauma (Injury Severity Score [ISS] 27.3 +/- 10, ARDS score 2.84 +/- 0.42). Patients who fulfilled the entry criteria (bilateral diffuse infiltrates, severe hypoxemia, pulmonary artery occlusion pressure [PAOP] < 18 mm Hg, and PaO2/fraction of inspired oxygen [FIO2] < 200 mm Hg at inverse ratio ventilation with positive end-expiratory pressure [PEEP] > 8 mm Hg for more than 24 h) were turned to the prone position at noon and were turned back to the supine position at 8:00 AM on the next day. Thus only two turns per day were necessary, and the risk of disconnecting airways or medical lines was minimized. Prone positioning was repeated for another 20 h if the patients fulfilled the entry criteria. Except for FIO2, the ventilator settings remained unchanged during the study period. All patients were sedated and, if needed paralyzed to minimize patient discomfort. One hour before and after each position change, ventilator settings and pulmonary and system...Continue Reading

References

May 1, 1979·The Journal of Pediatrics·M J WagamanW W Fox
Nov 16, 1979·JAMA : the Journal of the American Medical Association·W M ZapolR G Miller
Nov 1, 1976·The Journal of Trauma·S P Baker, B O'Neill
Jan 1, 1976·Critical Care Medicine·M A Piehl, R S Brown
Jun 1, 1992·Journal of Applied Physiology·K C BeckK Rehder
Sep 1, 1988·The American Review of Respiratory Disease·J F MurrayM R Flick
Jul 1, 1988·Chest·M LangerL Gattinoni
May 1, 1966·Journal of Applied Physiology·K KanekoD V Bates
Feb 26, 1981·The New England Journal of Medicine·C RemolinaN H Edelman
Jan 5, 1995·The New England Journal of Medicine·M H Kollef, D P Schuster
Jan 25, 1995·JAMA : the Journal of the American Medical Association·J A MilbergL D Hudson
Jul 1, 1994·American Journal of Respiratory and Critical Care Medicine·W J LammR K Albert
Jul 1, 1994·Der Anaesthesist·C HörmannS Hartlieb
Oct 1, 1993·Journal of Cardiothoracic and Vascular Anesthesia·T BrüsselP Lawin
Jan 1, 1961·Journal of Applied Physiology·F MORENO, H A LYONS

❮ Previous
Next ❯

Citations

Jul 15, 2005·JAMA : the Journal of the American Medical Association·Martha A Q CurleyJohn H Arnold
Jul 19, 2002·Chest Surgery Clinics of North America·Steven A Conrad, Akhil Bidani
Nov 30, 2000·Journal of Advanced Nursing·A N BreiburgJ D Pierce
Dec 1, 1999·Critical Care Medicine·G VoggenreiterK P Schmit-Neuerburg
Dec 1, 1999·Critical Care Medicine·R K Albert
Sep 29, 2000·Critical Care Medicine·R C McIntyreE Abraham
Jan 17, 2003·Critical Care Medicine·Jeanette R M White, Heidi J Dalton
Jun 5, 2002·The Journal of Trauma·Andrew J MichaelsWilliam B Long
Jul 20, 2002·Current Opinion in Pediatrics·Ronald B Hirschl
Jan 25, 2008·Critical Care Medicine·Abdullah H Alsaghir, Claudio M Martin
Aug 4, 2006·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Lori D FinemanMartha A Q Curley
Oct 30, 2004·The Journal of Trauma·Yoram KleinErik S Barquist
Nov 19, 2005·The Journal of Trauma·Gregor VoggenreiterDieter Nast-Kolb
May 23, 1998·Acta Anaesthesiologica Scandinavica·H FlaattenO Hevrøy
Aug 21, 2001·Critical Care : the Official Journal of the Critical Care Forum·P H van der Voort, D F Zandstra
Oct 10, 2001·Chest·R G BrowerM A Matthay
May 1, 2009·Archivos de bronconeumología·Oscar MartínezAndrés Esteban
Mar 21, 2007·Critical Care Clinics·Ferdinand R RicoEdward S Piotrowski
Feb 10, 2007·Annales Françaises D'anesthèsie Et De Rèanimation·M-S MebazaaM-S Ben Ammar
Nov 7, 2006·Clinics in Chest Medicine·Antonio Anzueto, Kalapatha Guntapalli
Jun 7, 2003·Anaesthesia·N MalarkkanA B Lumb
Apr 29, 2000·Intensive & Critical Care Nursing : the Official Journal of the British Association of Critical Care Nurses·C Ball
Jun 13, 2006·Seminars in Thoracic and Cardiovascular Surgery·Terrell A SingletonDennis C Gore
Apr 18, 2006·Journal of Critical Care·Martha A Q CurleyUNKNOWN Pediatric Prone Positioning Study Group
Oct 6, 2000·Clinics in Chest Medicine·R K Albert
Jun 20, 2001·Pediatric Clinics of North America·D Bohn
Sep 11, 2004·Critical Care Nursing Clinics of North America·Kathleen M Vollman
Jun 7, 1997·Lancet·N R Webster
Jul 13, 2016·Chest·Eric L ScholtenAtul Malhotra

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.