Source: Annual Congress 2002 - Monitoring respiratory parameters in critically ill patients
Disease area: Respiratory critical care

Abstract

Objective: The influence of prone positioning (PP), during mechanical ventilation in non-ARDS hypoxemic patients.
Material and Methods: Fifty-four non-ARDS hypoxemic patients, who after being mechanically ventilated for at least 6 h, needed an FiO₂>= 0,6 to achieve an PO₂[lte]60 mmHg , were turned to the prone position. Patients were divided in 5 groups. Group A, included 10 patients with pulmonary contusions, 4 of them with flail chest. Group B included 8 patients with pulmonary fibrosis (PF). Group C, included 9 patients with COPD, group D 10 patients with pneumonia, and group E included 17 patients with minor findings in lung radiography, indicative of sectional atelectasis, 6 of them with multiple trauma, 5 with neurotrauma, and 6 with cerebrovascular disease. Arterial blood gas was measured before the PP and 6 h from the beginning of the PP. FiO₂, and ventilator settings remained unchanged during the study period.
Results: The PaO₂/FiO₂ ratio before the PP and 6 h after the PP, was for group A 84,15 (range 76,6-93,3) and 154,15 (range 130-166,6) respectively, p=0,005, for group B 80 (range 75-83,3) and 81,65 (range 75-91,6), p=0,575, for group C 80 (range 75-88,3) and 83,30 (range 75-83,3), p=0,251, for group D 95,80 (range 90-100) and 164,15 (range 143,3-213,3), p=0,005 and for group E 96,60 (range 88,3-99,6) before and 163,30 (range 146,6-216,6), 6 h after the beginning of the PP, p<0,0005. Groups B and C did not improve significantly despite the repeated periods of PP.
Conclusions: The PP seems to be a safe method for the improvement of the oxygenation in non-ARDS hypoxemic patients, except in COPD and PF, where seems to be ineffective.

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E. Kostadima, I. Mavrou, M. Mpaka, G. Garoufalis, M. Alexopoulos, B. Koulouras, A. Androutsos, D. Sfiras (Larissa, Greece). The influence of prone positioning during mechanical ventilation in non-ARDS hypoxaemic patients. Eur Respir J 2002; 20: Suppl. 38, 617

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