التفاصيل البيبلوغرافية
| العنوان: |
The oxygenation variations related to prone positioning during mechanical ventilation: a clinical comparison between ARDS and non-ARDS hypoxemic patients. |
| المؤلفون: |
Venet, Christophe, Guyomarc'h, Stephane, Migeot, Christine, Bertrand, Monique, Gery, Pierre, Page, Dominique, Vermesch, Regine, Bertrand, Jean, Zeni, Fabrice, Venet, C, Guyomarc'h, S, Migeot, C, Bertrand, M, Gery, P, Page, D, Vermesch, R, Bertrand, J C, Zeni, F |
| المصدر: |
Intensive Care Medicine; Aug2001, Vol. 27 Issue 8, p1352-1359, 8p |
| مصطلحات موضوعية: |
CRITICAL care medicine, CLINICAL medicine, INTENSIVE care units, ARTIFICIAL respiration, RESPIRATORY therapy, RESUSCITATION, ADULT respiratory distress syndrome treatment, OXYGEN metabolism, ANALYSIS of variance, COMPARATIVE studies, LONGITUDINAL method, LYING down position, RESEARCH methodology, MEDICAL cooperation, NONPARAMETRIC statistics, RESEARCH, SUPINE position, EVALUATION research, POSITIVE end-expiratory pressure |
| مستخلص: |
Objectives: To compare, in clinical practice, the oxygenation variations related to prone positioning (PP) during mechanical ventilation in ARDS and non-ARDS hypoxemic patients. Design and setting: Prospective observational study of data on consecutive patients treated with the same protocol in the intensive care unit (ICU) of a university hospital. Patients: From May 1996 to December 1998, 226 PP periods without adjunction of nitric oxide (NO) inhalation and/or almitrine bismesylate infusion, performed in 59 mechanically ventilated hypoxemic patients (arterial oxygen tension/fractional inspired oxygen (PaO2/FIO2) ratio <300 mmHg) with no evidence of left ventricular failure, were included in this study. Measurements: Arterial blood gas was measured before the PP, at 1 h from the beginning of the PP, at the end of the PP and 1 h after returning to the supine position. Results: We analyzed 136 PP periods in 34 non-ARDS patients (60.2%) and 90 in 25 ARDS patients. The PP was repeated and the duration of the PP periods was: 10.6±0.22 h. The PP during the mechanical ventilation appeared to be safe and well tolerated. A PaO2/FIO2 ratio improvement at the end of the PP period, occurred for 196 periods (86.7%) with a mean PaO2/FIO2 ratio increase of +46.4±0.03% at the end of the PP periods compared to the baseline supine value. The PaO2/FIO2 ratio variations at 1 h after the start of the PP, at the end of the PP period and at 1 h after the return to supine were not different in ARDS or non-ARDS hypoxemic patients. The PaO2/FIO2 ratio improvement appeared to be more intense and more rapid in ARDS patients. Conclusions: In about 90% of periods, PP improved the PaO2/FIO2 ratio in patients with ARDS as well as in hypoxemic patients with non-ARDS. Studies are necessary to determine the impact of PP on survival and the mechanical ventilation duration in ARDS or non-ARDS hypoxemic patients. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
