Document Detail


Is a short trial of prone positioning sufficient to predict the improvement in oxygenation in patients with acute respiratory distress syndrome?
MedLine Citation:
PMID:  11497137     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether a 1-h trial of prone positioning is sufficient to identify responders. DESIGN: Prospective clinical cohort study in a medico-surgical ICU in a teaching hospital. PATIENTS: 49 patients with acute respiratory distress syndrome. INTERVENTIONS: A 6-h period of prone positioning. MEASUREMENTS AND RESULTS: Baseline measurements (blood gas analysis and respiratory parameters) were evaluated in supine position just prior to turning the patients prone. Measurements were then repeated 1 h after the beginning of prone positioning (PP1h) and at the end of the 6-h period of prone positioning (PP6h). The last measurements were performed 1 h after repositioning the patients supine. Prone position induced an increase in the PaO2/FIO2 ratio (p < 0.001). A response (increase in PaO2/FIO2 ratio of at least 20 % at PP1h and/or at PP6h) was observed in 37 of 49 patients (76%). Twenty-seven of these patients (73%) were responders at PP1h while 10 (27%) were responders only at PP6h- In all, two-thirds of the patients were considered persistent responders. However, whereas the PaO2/FIO2 ratio decreased significantly 1 h after repositioning the fast responders supine, the PaO2/ FIO2 ratio remained unchanged after repositioning slow responders. CONCLUSIONS: A short-term trial of prone positioning does not appear a sufficient method to identify patients who would benefit from the postural treatment.
Authors:
L Papazian; M H Paladini; F Bregeon; L Huiart; X Thirion; P Saux; Y Jammes; J P Auffray
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  27     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-08-10     Completed Date:  2001-12-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1044-9     Citation Subset:  IM    
Affiliation:
Service de Réanimation Médicale, Hĵpitaux Sud, Marseille, France. lpapazian@mail.ap-hm.fr
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MeSH Terms
Descriptor/Qualifier:
APACHE
Blood Gas Analysis
Female
Humans
Intensive Care Units
Male
Middle Aged
Positive-Pressure Respiration
Predictive Value of Tests
Prone Position
Prospective Studies
Respiration*
Respiratory Distress Syndrome, Adult / classification,  therapy*
Time Factors

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


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