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"Prone ventilation" "ARDS"

Eric L Scholten, Jeremy R Beitler, G Kim Prisk, Atul Malhotra
Prone positioning was first proposed in the 1970s as a method to improve gas exchange in the acute respiratory distress syndrome (ARDS). Subsequent observations of dramatic improvement in oxygenation with simple patient rotation motivated the next several decades of research. This work elucidated the physiology mechanisms underlying changes in gas exchange and respiratory mechanics with prone ventilation. However, translating physiological improvements into a clinical benefit has proven challenging; several contemporary trials showed no major clinical benefits with proning...
July 8, 2016: Chest
Tanmay S Panchabhai, Debabrata Bandyopadhyay, Aanchal Kapoor, Olufemi Akindipe, Charles Lane, Sudhir Krishnan
Prone position ventilation (PPV) improves mortality in severe acute respiratory distress syndrome (ARDS), but outcomes following its use in lung transplant recipients are not known. We report the case of a 42-year-old Caucasian man who presented with severe ARDS from Bordetella pertussis, 5 years after bilateral sequential lung transplant for cystic fibrosis. He was managed with PPV for 22 days and had a prolonged ICU stay complicated by hypoxic ischemic optic neuropathy leading to blindness. Since his discharge from the ICU 6 months ago, his FEV1 has recovered to 47% predicted compared to his pre-ICU peak FEV1 of 85% predicted, suggesting recovery of lung function...
January 2016: International Journal of Critical Illness and Injury Science
Yiping Wang, Fei Xiao, Jiajia Li, Hong Pu, Xiaobo Huang
OBJECTIVE: To investigate the ideal persistence time of prone position ventilation in patients with severe acute respiratory distress syndrome (ARDS). METHODS: Collect 78 cases of severe ARDS admitted to the ICU unit of Sichuan Provincial People's Hospital from October 2012 to June 2014, all the ARDS patients needed to receive 8 h/day prone position continuous 5 day. For each of the prone position ventilation, ultrasound patterns were recorded and the aeration scores were calculated at the beginning of the prone position (T0) and 2 h (T1), 4 h (T2), 6 h (T3), 8 h (T4) later...
May 19, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
V A Shtabnitskiy, A G Chuchalin
The paper reviews the state-of-the-art of acute respiratory distress syndrome (ARDS) and current approaches to correcting respiratory failure. It highlights the historical and present-day data on the efficiency of extracorporeal membrane hemoxygenation, high-frequency ventilation, surfactant and inhaled nitric oxide therapy, and prone ventilation. The examinations have shown that ventilation in the prone position and extracorporeal membrane hemoxygenation not only improve gas exchange, but have a positive prognostic impact...
2014: Terapevticheskiĭ Arkhiv
J A Mora-Arteaga, O J Bernal-Ramírez, S J Rodríguez
INTRODUCTION: Prone position ventilation has been shown to improve oxygenation and ventilatory mechanics in patients with acute respiratory distress syndrome. We evaluated whether prone ventilation reduces the risk of mortality in adult patients with acute respiratory distress syndrome versus supine ventilation. METHODOLOGY: A metaanalysis of randomized controlled trials comparing patients in supine versus prone position was performed. A search was conducted of the Pubmed, Embase, Cochrane Library, and LILACS databases...
August 2015: Medicina Intensiva
J Claesson, M Freundlich, I Gunnarsson, J H Laake, P O Vandvik, T Varpula, T A Aasmundstad
BACKGROUND: The objective of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) task force on mechanical ventilation in adults with the acute respiratory distress syndrome (ARDS) is to formulate treatment recommendations based on available evidence from systematic reviews and randomised trials. METHODS: This guideline was developed according to standards for trustworthy guidelines through a systematic review of the literature and the use of the Grading of Recommendations Assessment, Development and Evaluation system for assessment of the quality of evidence and for moving from evidence to recommendations in a systematic and transparent process...
March 2015: Acta Anaesthesiologica Scandinavica
Younsuck Koh
Acute respiratory distress syndrome (ARDS) is characterized by permeability pulmonary edema and refractory hypoxemia. Recently, the new definition of ARDS has been published, and this definition suggested severity-oriented respiratory treatment by introducing three levels of severity according to PaO2/FiO2 and positive end-expiratory pressure. Lung-protective ventilation is still the key of better outcome in ARDS. Through randomized trials, short-term use of neuromuscular blockade at initial stage of mechanical ventilation, prone ventilation in severe ARDS, and extracorporeal membrane oxygenation in ARDS with influenza pneumonia showed beneficial efficacy...
2014: Journal of Intensive Care
Xin Ding, Dawei Liu, Xiaoting Wang, Chunxian Wang, Hongmin Zhang, Ye Liu, Huan Chen, Bo Tang, Wei Du
OBJECTIVE: To investigate the value of prone position lung ultrasound examination (PLUE) in monitoring the prone position during and predicting the outcome of Acute Respiratory Distress Syndrome (ARDS) patients. METHODS: All the ARDS patients needed to receive prone position were enrolled, a three hours PLUE was performed during the prone position for the first time. For each of the 16 regions examined, ultrasound patterns were recorded and the aeration scores were calculated at the beginning of the prone position and 3 hours later...
September 2014: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Alexander B Benson, Richard K Albert
Multiple animal and human studies have shown that prone positioning improves oxygenation and reduces ventilator-induced lung injury (VILI) in the setting of acute lung injury or acute respiratory distress syndrome (ARDS). In this article, the physiologic changes explaining the improvement in oxygenation are reviewed, how prone positioning reduces VILI is described, randomized controlled trials of prone ventilation in patients with ARDS are evaluated, the complications associated with prone ventilation are summarized, suggestions are made as to how these might be reduced or avoided, and when prone ventilation should start and stop and for what duration it should be used are discussed...
December 2014: Clinics in Chest Medicine
Rodrigo Cornejo, Carlos Romero, Diego Ugalde, Patricio Bustos, Gonzalo Diaz, Ricardo Galvez, Osvaldo Llanos, Eduardo Tobar
We report the successful treatment of two patients with aneurismal subarachnoid hemorrhage complicated by severe respiratory failure and refractory septic shock using simultaneous prone position ventilation and high-volume hemofiltration. These rescue therapies allowed the patients to overcome the critical situation without associated complications and with no detrimental effects on the intracranial and cerebral perfusion pressures. Prone position ventilation is now an accepted therapy for severe acute respiratory distress syndrome, and high-volume hemofiltration is a non-conventional hemodynamic support that has several potential mechanisms for improving septic shock...
April 2014: Revista Brasileira de Terapia Intensiva
Claude Guérin
Prone positioning has been used for many years in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), with no clear benefit for patient outcome. Meta-analyses have suggested better survival in patients with an arterial oxygen tension (PaO2 )/inspiratory oxygen fraction (FIO2 ) ratio <100 mmHg. A recent randomised controlled trial was performed in ARDS patients after a 12-24 h stabilisation period and severity criteria (PaO2 /FIO2 <150 mmHg at a positive end-expiratory pressure ≥5 cmH2O)...
June 2014: European Respiratory Review: An Official Journal of the European Respiratory Society
Kapil Dev Soni, Sukhen Samanta, Richa Aggarwal, Sujay Samanta
Prone ventilation for refractory acute respiratory distress syndrome (ARDS) mandates free abdomen by rolls in between chest wall and pelvic bones for better ventilation and control of airway pressure. We observed that, in patients with severe ARDS, prone ventilation with movable free abdomen produced high plateau pressure reduced by applying simple support to abdominal wall. Here, we have proposed a possible hypothesis to explain the paradoxical event in this particular group of patients. The increased alveolar volume in prone position is counteracted by reduction in rib cage diameter caused by weight of abdomen...
October 2014: American Journal of Emergency Medicine
Parikshit Singh, Rajshree Ramasethu, Amit Sharma
No abstract text is available yet for this article.
January 2014: Medical Journal, Armed Forces India
Sukhen Samanta, Sujay Samanta, Jyotsna Wig, A K Baronia
We encountered a case of severe acute respiratory distress syndrome in late pregnancy due to influenza (H1N1) with refractory hypoxemia to conventional mechanical ventilation. Ventilation in prone position rescued this patient by maintaining oxygenation and sustaining improvement thereafter. Here, we discuss the mechanism of prone ventilation with special references to safety management of acute respiratory distress syndrome in the third trimester of pregnancy. It requires frequent monitoring of possible complications due to prone position and highly dedicated supporting staffs...
June 2014: American Journal of Emergency Medicine
Joo Myung Lee, Won Bae, Yeon Joo Lee, Young-Jae Cho
OBJECTIVE: The survival benefit of prone positioning during mechanical ventilation for acute respiratory distress syndrome has been a matter of debate. Recent multicenter randomized controlled trials have shown a significant reduction of 28-day and 90-day mortality associated with prone positioning during mechanical ventilation for severe acute respiratory distress syndrome. We performed an up-to-date meta-analysis on this topic and elucidated the effect of prone positioning on overall mortality and associated complications...
May 2014: Critical Care Medicine
Sukhen Samanta, Sujay Samanta, Kapil Dev Soni
Prone ventilation is usually used for severe acute respiratory distress syndrome. We applied an alternative method to prone position. We described 2 cases of trauma where prone position could not be done. Chest wall compression was performed by 2-kg weight in front of the chest wall bilaterally while the patient was in a supine position. Respiratory mechanics work to improve oxygenation almost as same as the mechanism proposed for prone position without any major adverse effects and serious complications. We suggest a larger randomized study to determine the efficacy and also to find out the optimum weight required to compress the chest...
May 2014: American Journal of Emergency Medicine
Kiran Shekar, Andrew R Davies, Daniel V Mullany, Ravindranath Tiruvoipati, John F Fraser
Ventilatory management of acute respiratory distress syndrome has evolved significantly in the last few decades. The aims have shifted from optimal gas transfer without concern for iatrogenic risks to adequate gas transfer while minimizing lung injury. This change in focus, along with improved ventilator and multiorgan system management, has resulted in a significant improvement in patient outcomes. Despite this, a number of patients develop hypoxemic respiratory failure refractory to lung-protective ventilation (LPV)...
October 2013: Journal of Critical Care
Dipankar Sarkar, Shruti Sarkar, Shweta Anand, Anju Kapoor
Acute respiratory distress syndrome (ARDS) is an acute respiratory condition caused by various pulmonary and extrapulmonary conditions including H1N1 virus infection. ARDS has a high mortality worldwide and in India various studies suggest that mortality in children is as high as 73-75%. Different lung protective ventilation strategies have recently been adopted to reduce mortality. The authors report a successful outcome in a 3.5-year-old child with ARDS secondary to H1N1 infection following use of a very low tidal volume (4-6 ml/kg) along with high positive end-expiratory pressure breathing and prone ventilation...
2011: BMJ Case Reports
A Rodríguez, L Alvarez-Rocha, J M Sirvent, R Zaragoza, M Nieto, A Arenzana, P Luque, L Socías, M Martín, D Navarro, J Camarena, L Lorente, S Trefler, L Vidaur, J Solé-Violán, F Barcenilla, A Pobo, J Vallés, C Ferri, I Martín-Loeches, E Díaz, D López, M J López-Pueyo, F Gordo, F del Nogal, A Marqués, S Tormo, M P Fuset, F Pérez, J Bonastre, B Suberviola, E Navas, C León
The diagnosis of influenza A/H1N1 is mainly clinical, particularly during peak or seasonal flu outbreaks. A diagnostic test should be performed in all patients with fever and flu symptoms that require hospitalization. The respiratory sample (nasal or pharyngeal exudate or deeper sample in intubated patients) should be obtained as soon as possible, with the immediate start of empirical antiviral treatment. Molecular methods based on nucleic acid amplification techniques (RT-PCR) are the gold standard for the diagnosis of influenza A/H1N1...
March 2012: Medicina Intensiva
Rakhi Balachandran, Suresh G Nair, Praveen C Sivadasan, Gopalraj S Sunil, Balu Vaidyanathan, Jithin K Sreedharan, Chris Sara Mathew
No abstract text is available yet for this article.
June 2012: Journal of Cardiothoracic and Vascular Anesthesia
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