Assessing Right Ventricular Performance During Prone Ventilation in ARDS Patients Using Speckle Tracking...

Area of Science:

• Cardiology
• Pulmonology
• Critical Care Medicine

Background:

• Acute respiratory distress syndrome (ARDS) often leads to right ventricular (RV) dysfunction due to increased pulmonary vascular resistance.
• Protective ventilation and prone positioning are key ARDS management strategies, with prone positioning showing benefits for oxygenation and RV function.

Purpose of the Study:

• To evaluate the impact of prone positioning on RV performance in ARDS patients using speckle tracking echocardiography (STE).

Main Methods:

• Observational, retrospective, single-center study of 16 mechanically ventilated ARDS patients.
• Transthoracic echocardiography with STE assessed RV function, including RV global longitudinal strain (GLS) and RV free wall strain (RVFWS), in supine and prone positions.

Main Results:

• Prone positioning significantly increased the PaO2/FiO2 ratio (p=0.004).
• No significant differences were observed in standard RV function parameters (e.g., TAPSE, RV FAC).
• However, prone positioning led to a significant decrease in RV GLS (p=0.009) and RVFWS (p=0.003).

Conclusions:

• Prone positioning may negatively impact RV systolic function in ARDS patients.
• STE-derived strain parameters show potential as sensitive markers for subclinical RV dysfunction.
• Larger, prospective studies are needed to validate these preliminary findings.