Document Detail


Dramatic effect on oxygenation in patients with severe acute lung insufficiency treated in the prone position.
MedLine Citation:
PMID:  9295829     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To confirm the positive effect of prone positioning on oxygenation in patients with acute lung insufficiency. DESIGN: Clinical follow-up study. SETTING: The intensive care unit at a tertiary care academic hospital. PATIENTS: Thirteen patients suffering from severe acute lung insufficiency caused by trauma, septicemia, aspiration, and burn injury. Eleven of the patients had severe hypoxia (oxygenation indices [PaO2/FIO2] < or = 80 torr [< or = 10.7 kPa]). Patients > 70 yrs of age were excluded from the study. INTERVENTIONS: Treatment in the prone position without changing other ventilatory settings than FIO2 when saturation increased. MEASUREMENTS AND MAIN RESULTS: Twelve of the 13 patients responded to treatment in the prone position. The patient that did not respond improved her gas exchange when nitric oxide was instituted. She died, however, from a Gram-negative septicemia. No patient needed extracorporeal membrane oxygenation. Apart from the settings of FIO2 when saturation increased, the ventilatory settings were unchanged. In the prone position, the oxygenation index increased (p < .0002) and the alveolar-arterial oxygen gradient, P(A-a)O2, decreased dramatically (p < .0001). CONCLUSIONS: The prone position significantly improves impaired gas exchange due to severe acute lung insufficiency. It is suggested that this treatment is used before more complex modalities.
Authors:
M Mure; C R Martling; S G Lindahl
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  25     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-10-02     Completed Date:  1997-10-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1539-44     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology and Intensive Care, Karolinska Hospital and Institute, Stockholm, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Female
Follow-Up Studies
Humans
Intensive Care
Male
Middle Aged
Oxygen / blood
Oxygen Consumption*
Prone Position*
Pulmonary Gas Exchange*
Respiratory Insufficiency / metabolism*,  physiopathology,  therapy*
Supine Position
Survival Analysis
Time Factors
Chemical
Reg. No./Substance:
7782-44-7/Oxygen
Comments/Corrections
Comment In:
Crit Care Med. 1997 Sep;25(9):1453-4   [PMID:  9295813 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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