| Prone positioning and acute respiratory distress syndrome after cardiac surgery: a feasibility study. | |
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MedLine Citation:
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PMID: 18503930 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the feasibility, safety, and efficacy on PaO(2)/F(I)O(2) ratio of prone positioning (PP) for acute respiratory distress syndrome (ARDS) after cardiac surgery. DESIGN: Retrospective review of information entered prospectively in the authors' database. SETTING: A private community nonteaching hospital. PARTICIPANTS: Sixteen patients who developed ARDS after cardiac surgery from January 2004 through June 2005. Interventions: PP to improve oxygenation. MEASUREMENTS AND MAIN RESULTS: After a median duration of 18 (range, 14-27) hours in PP, PaO(2)/F(I)O(2) improved in 14 (87.5%) patients. For the entire population, median PaO(2)/F(I)O(2) rose from 87 (range, 56-161) before PP to 194 (range, 94-460; p < 0.05) after it. After supine repositioning (SR), PaO(2)/F(I)O(2) declined to 146 (range, 72-320; not significant). PaO(2)/F(I)O(2) at the end of PP and 1 day after SR were comparable, respectively, 194 (range, 94-460) and 184 (range, 105-342). No severe complication was associated with PP, but 5 patients developed pressure sores and 2 others had superficial sternal wound infections. Intensive care unit mortality of 37.5% reflected the number of organ failure(s); there were no deaths with 2 failures, and 60% with > or = 3 organ failures died (p = 0.03). Mortality rates were comparable regardless of whether patients were PaO(2)/F(I)O(2) responders or their PaCO(2) decreased by > or = 1 mmHg. CONCLUSION: PP to treat ARDS after cardiac surgery is feasible, safe, and can efficiently improve oxygenation. Measures to prevent pressure sores are mandatory. |
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Authors:
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Jean-Michel Maillet; Stéphane Thierry; Denis Brodaty |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-01-22 |
Journal Detail:
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Title: Journal of cardiothoracic and vascular anesthesia Volume: 22 ISSN: 1532-8422 ISO Abbreviation: J. Cardiothorac. Vasc. Anesth. Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-05-27 Completed Date: 2008-10-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9110208 Medline TA: J Cardiothorac Vasc Anesth Country: United States |
Other Details:
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Languages: eng Pagination: 414-7 Citation Subset: IM |
Affiliation:
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Cardiovascular and Thoracic Surgery Intensive Care Unit, Centre Cardiologique du Nord, Saint-Denis Cedex, France. jm.maillet@ccncardio.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Cardiovascular Surgical Procedures / adverse effects* Feasibility Studies Female Humans Male Middle Aged Prone Position / physiology* Prospective Studies Respiratory Distress Syndrome, Adult / etiology, physiopathology*, prevention & control* Retrospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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