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[Continuously alternating prone and supine positioning in acute lung failure]
Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|November 1, 1992
Summary
Changing patient position to prone improves oxygen levels in acute respiratory failure patients, allowing for reduced oxygen concentration. This method offers a potential therapeutic strategy for improving outcomes in surgical intensive care units.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
- Surgical Intensive Care
Background:
- Acute respiratory failure (ARF) poses a significant challenge in surgical intensive care.
- Current treatments focus on symptomatic therapy due to unknown pathophysiological mechanisms.
- Established ventilatory strategies like PEEP and IRV aim to improve gas exchange and lung function.
Purpose of the Study:
- To investigate the effects of continuous prone and supine positioning on mechanical ventilation in patients with ARF.
- To assess the impact of prone positioning on oxygenation and the need for supplemental oxygen.
Main Methods:
- 16 male patients with ARF, predominantly trauma patients, were included.
- Continuous alternation between prone and supine positions was employed under mechanical ventilation.
- Patients were monitored for blood gas analysis, specifically PaO2, to guide position changes.
Main Results:
- Prone positioning led to an average increase in PaO2 of 48 mmHg.
- Fraction of inspired oxygen (FiO2) could be reduced by an average of 0.2 within 48 hours of position changes.
- No adverse effects on blood pressure or mechanical ventilation were observed during prone positioning.
Conclusions:
- Continuous prone and supine positioning is a viable strategy for improving oxygenation in ARF patients.
- This positional therapy can reduce the requirement for high FiO2.
- The study observed a survival rate of 68.8% in patients managed with this approach.