Document Detail

Can the tomographic aspect characteristics of patients presenting with acute respiratory distress syndrome predict improvement in oxygenation-related response to the prone position?
MedLine Citation:
PMID:  12218526     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In some patients with acute respiratory distress syndrome, the prone position is able to improve oxygenation, whereas in others it is not. It could be hypothesized that the more opacities that are present in dependent regions of the lung when the patient is in the supine position, the better the improvement in oxygenation is observed when the patients are turned prone. Therefore, we conducted a prospective study to identify computed tomographic scan aspects that could accurately predict who will respond to the prone position. METHODS: We included 46 patients with acute respiratory distress syndrome (31 responders and 15 nonresponders). Computed tomographic scan was performed in the 6-h period preceding prone position. Blood gas analyses were performed before and at the end of the first 6-h period of prone position. RESULTS: Arterial oxygen partial pressure/fraction of inspired oxygen increased from 117 +/- 42 (mean +/- SD) in the supine position to 200 +/- 76 mmHg in the prone position (P < 0.001). There were 31 responders and 15 nonresponders. There was a vertebral predominance of the opacities (P < 0.0001). However, there was no difference between responders and nonresponders. When only the amount of consolidated lung located under the heart was evaluated, there was more consolidated tissue under the heart relative to total lung area in nonresponders than in responders (P = 0.01). CONCLUSIONS: There are no distinctive morphologic features in the pattern of lung disease measured by computed tomographic scanning performed with the patient in the supine position that can predict response to the prone position.
Laurent Papazian; Marie-Héléne Paladini; Fabienne Bregeon; Xavier Thirion; Olivier Durieux; Marc Gainnier; Laetitia Huiart; Serge Agostini; Jean-Pierre Auffray
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Anesthesiology     Volume:  97     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-09     Completed Date:  2002-09-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  599-607     Citation Subset:  AIM; IM    
Polyvalent Intenstive Care Unit, Hôpital Sainte-Marguerite, Marseille, France.
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MeSH Terms
Blood Gas Analysis
Heart / physiopathology
Lung / physiopathology,  radiography
Middle Aged
Oxygen / blood
Oxygen Inhalation Therapy*
Predictive Value of Tests
Prone Position / physiology*
Prospective Studies
Respiratory Distress Syndrome, Adult / radiography*,  therapy*
Respiratory Function Tests
Tomography, X-Ray Computed
Treatment Outcome
Reg. No./Substance:

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