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pronation mechanical ventilation

Kristy Gibson, Marlene Dufault, Kathy Bergeron
Acute respiratory distress syndrome (ARDS) is a condition with a high morbidity and mortality rate, and treatment is often long and costly. Prone positioning is a rarely used intervention for patients with this syndrome, although research suggests it may be effective. A literature search was undertaken to examine the effects of prone positioning on oxygenation, morbidity and mortality in patients with ARDS. It revealed that prone positioning, when used with low tidal volume ventilation over an extended period, may reduce mortality rates in selected patients with severe ARDS...
August 12, 2015: Nursing Standard
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
Carlos M Romero, Rodrigo A Cornejo, L Ricardo Gálvez, Osvaldo P Llanos, Eduardo A Tobar, M Angélika Berasaín, Daniel H Arellano, Jorge F Larrondo, José S Castro
OBJECTIVES: The aim of the study was to evaluate the safety of extended prone position ventilation (PPV) and its impact on respiratory function in patients with severe acute respiratory distress syndrome (ARDS). DESIGN: This was a prospective interventional study. SETTING: Patients were recruited from a mixed medical-surgical intensive care unit in a university hospital. PATIENTS: Fifteen consecutive patients with severe ARDS, previously unresponsive to positive end-expiratory pressure adjustment, were treated with PPV...
March 2009: Journal of Critical Care
S D Mentzelopoulos, J Sigala, C Roussos, S G Zakynthinos
Based on prior data, the current authors hypothesised that beneficial pronation effects on gas exchange and respiratory mechanics might be maximised in severely hyperinflated chronic bronchitis patients. The current authors also sought to elucidate underlying mechanisms and to determine whether pronation effects are reflected by postural changes in inspiratory pressure-volume (P-V) curve characteristics. A total of 16 mechanically ventilated patients (for 16-36 h) with chronic bronchitis exacerbation were studied in pre-prone semirecumbent (SREC), prone and post-prone SREC postures...
July 2006: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Spyros D Mentzelopoulos, Charis Roussos, Spyros G Zakynthinos
OBJECTIVE: In acute respiratory distress syndrome the body posture effects on pressure-volume (PV) curves are still unclear. We examined the effects of prone position on inflation PV curves and their potential relationships with postural alterations in gas exchange. DESIGN AND SETTING: Prospective study with patients serving as their own controls in a university-affiliated 30-bed intensive care unit. PATIENTS AND PARTICIPANTS: Thirteen anesthetized, paralyzed, semirecumbent, mechanically ventilated patients with early/severe/diffuse ARDS...
December 2005: Intensive Care Medicine
S D Mentzelopoulos, C Roussos, S G Zakynthinos
The present authors hypothesised that in severe acute respiratory distress syndrome (ARDS), pronation may reduce ventilator-induced overall stress (i.e. transpulmonary pressure (P(L))) and strain of lung parenchyma (i.e. tidal volume (V(T))/end-expiratory lung volume (EELV) ratio), which constitute major ventilator-induced lung injury determinants. The authors sought to determine whether potential pronation benefits are maintained in post-prone semirecumbent (SR(PP)) posture under pressure-volume curve-dependent optimisation of positive end-expiratory pressure (PEEP)...
March 2005: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
S D Mentzelopoulos, C Roussos, S G Zakynthinos
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...
February 2005: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Spyros D Mentzelopoulos, Spyros G Zakynthinos, Charris Roussos, Maria J Tzoufi, Argyris S Michalopoulos
UNLABELLED: Pronation might favorably affect respiratory system (rs) mechanics and function in volume-controlled, mode-ventilated chronic obstructive pulmonary disease (COPD) patients. We studied 10 COPD patients, initially positioned supine (baseline supine [supine(BAS)]) and then randomly and consecutively changed to protocol supine (supine(PROT)), semirecumbent, and prone positions. Rs mechanics and inspiratory work (W(I)) were assessed at baseline (0.6 L) (all postures) and sigh (1...
June 2003: Anesthesia and Analgesia
P Pelosi, L Brazzi, L Gattinoni
In the last few years prone positioning has been used increasingly in the treatment of patients with acute respiratory distress syndrome (ARDS) and this manoeuvre is now considered a simple and safe method to improve oxygenation. However, the physiological mechanisms causing respiratory function improvement as well as the real clinical benefit are not yet fully understood. The aim of this review is to discuss the physiological and clinical effects of prone positioning in patients with ARDS. The main physiological aims of prone positioning are: 1) to improve oxygenation; 2) to improve respiratory mechanics; 3) to homogenise the pleural pressure gradient, the alveolar inflation and the ventilation distribution; 4) to increase lung volume and reduce the amount of atelectatic regions; 5) to facilitate the drainage of secretions; and 6) to reduce ventilator-associated lung injury...
October 2002: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
R D Hubmayr, J R Rodarte, B J Walters, F M Tonelli
We evaluated the effects of the different patterns of chest wall deformation that occur with different body positions and modes of breathing on regional lung deformation and ventilation. Using the parenchymal marker technique, we determined regional lung behavior during mechanical ventilation and spontaneous breathing in five anesthetized recumbent dogs. Regional lung behavior was related to the patterns of diaphragm motion estimated from X-ray projection images obtained at functional residual capacity (FRC) and end inspiration...
December 1987: Journal of Applied Physiology
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No abstract text is available yet for this article.
May 5, 1990: Lancet
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