Document Detail

Prone position improves expiratory airway mechanics in severe chronic bronchitis.
MedLine Citation:
PMID:  15684289     Owner:  NLM     Status:  MEDLINE    
Based on lung parenchyma-airways' interdependence, the present authors hypothesised that prone positioning may reduce airway resistance in severe chronic bronchitis. A total of 10 anaesthetised/mechanically ventilated patients were enrolled. Partitioned respiratory system (RS) mechanics during iso-flow experiments (flow = 0.91 L x s(-1), tidal volume (VT) varied within 0.2-1.2 L), haemodynamics, gas-exchange, expiratory airway resistance (Raw,exp), functional residual capacity (FRC), change in FRC (DeltaFRC), end-expiratory lung volume (EELV), expiratory airway resistance at EELV (Raw,exp,EELV), intrinsic positive end-expiratory pressure (PEEPi), and mean end-expiratory flow were determined in baseline semirecumbent (SRBAS), prone, and post-prone semirecumbent (SRPP) postures. Pronation versus SRBAS resulted in significantly reduced Raw,exp (at VT > or =0.8 L), Raw,exp,EELV (18.3+/-1.4 versus 31.6+/-2.6 cm H2O x L(-1) x s(-1)), inspiratory airway resistance (at VT > or =1.0 L), static lung elastance (at VT < or =0.6 L), "additional" RS/lung resistance (at a range of VTs), DeltaFRC (0.35+/-0.03 versus 0.47+/-0.03 L), EELV (4.92+/-0.49 versus 5.65+/-0.65 L), RS/lung PEEPi (6.7+/-1.1/5.4+/-0.6 versus 8.9+/-1.7/7.8+/-1.1 cm H2O), mean end-expiratory flow (63.9+/-4.2 versus 47.9+/-4.0 mL x s(-1)), and shunt fraction (0.16+/-0.03 versus 0.21+/-0.03); benefits were reversed in SRPP. In severe chronic bronchitis, prone positioning reduces airway resistance and dynamic hyperinflation.
S D Mentzelopoulos; C Roussos; S G Zakynthinos
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The European respiratory journal     Volume:  25     ISSN:  0903-1936     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-02-01     Completed Date:  2005-05-03     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  259-68     Citation Subset:  IM    
University of Athens Medical School, Dept of Intensive Care Medicine, Attikon University Hospital, Athens, Greece.
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MeSH Terms
Airway Resistance / physiology
Analysis of Variance
Bronchitis, Chronic / physiopathology*
Hemodynamics / physiology
Middle Aged
Prone Position / physiology*
Pulmonary Gas Exchange / physiology
Respiratory Function Tests
Respiratory Mechanics / physiology*

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