Related Experiment Video
Updated: Jun 4, 2025
07:16
An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
3.1K
Prone Positioning for Acute Respiratory Failure after PEA: An Initial Experience.
Koray Ak1, Majd Tarazi2, Fatih Öztürk2
1Department of Cardiovascular Surgery, Marmara University School of Medicine, Marmara Uninersitesi Hastanesi Mimar Sinan Cad. Fevzi cakmak mah. Ust kaynarca kalp ve damar Cerrahisi Bolumu Pendik, Istanbul, Turkey.
The Thoracic and Cardiovascular Surgeon
|December 24, 2024
Summary
Prone positioning (PP) improved oxygenation in patients with acute respiratory failure after pulmonary endarterectomy (PEA). However, PP increased the risk of ventilator-associated pneumonia, necessitating further research with larger sample sizes.
Area of Science:
- Critical Care Medicine
- Respiratory Medicine
- Surgical Outcomes
Background:
- Acute respiratory failure is a serious complication following pulmonary endarterectomy (PEA).
- Prone positioning (PP) is a therapeutic option for severe hypoxemia.
Purpose of the Study:
- To evaluate the efficacy and safety of prone positioning (PP) in patients experiencing acute respiratory failure after pulmonary endarterectomy (PEA).
Main Methods:
- Retrospective analysis of 125 patients who underwent PEA.
- Analysis of outcomes for 13 patients who received PP for acute respiratory failure post-surgery.
- Multivariate logistic stepwise analysis to identify predictors of PP and its complications.
Main Results:
- PP significantly improved the arterial oxygen to fraction of inspired oxygen ratio (PaO2/FiO2) (p=0.0002).
- Ventilator-associated pneumonia (VAP) was the most common complication (70%), with PP being an independent predictor (OR: 10.3).
- Need for inotropy and low preoperative cardiac index predicted PP use; early mortality was 23%.
Conclusions:
- Prone positioning (PP) is a feasible option for early management of acute respiratory failure post-pulmonary endarterectomy (PTE).
- Increased risk of ventilator-associated pneumonia (VAP) is associated with PP.
- Larger studies are required to confirm these findings and optimize PP protocols.
Related Concept Videos
01:23Acute Respiratory Failure-IV
125
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
125
01:11Anatomical Positions
9.7K
In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
9.7K
01:29Acute Respiratory Failure-V
123
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
123
01:30Acute Respiratory Failure-III
156
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
156
01:21Acute Respiratory Failure-II
173
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
173
01:30Pneumonia V: Nursing management and Prevention
1.9K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
1.9K