Lung volumes and lung volume recruitment in ARDS : a comparison between supine and prone position
Aguirre-Bermeo, Hernan (Institut d'Investigació Biomèdica Sant Pau)
Turella, Marta (Institut d'Investigació Biomèdica Sant Pau)
Bitondo, Maddalena (Institut d'Investigació Biomèdica Sant Pau)
Grandjean, Juan (Institut d'Investigació Biomèdica Sant Pau)
Italiano, Stefano (Institut d'Investigació Biomèdica Sant Pau)
Festa, Olimpia (Institut d'Investigació Biomèdica Sant Pau)
Morán, Indalecio (Institut d'Investigació Biomèdica Sant Pau)
Mancebo, Jordi (Jordi) (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Date:	2018
Abstract:	The use of positive end-expiratory pressure (PEEP) and prone position (PP) is common in the management of severe acute respiratory distress syndrome patients (ARDS). We conducted this study to analyze the variation in lung volumes and PEEP-induced lung volume recruitment with the change from supine position (SP) to PP in ARDS patients. The investigation was conducted in a multidisciplinary intensive care unit. Patients who met the clinical criteria of the Berlin definition for ARDS were included. The responsible physician set basal PEEP. To avoid hypoxemia, FiO was increased to 0. 8 1 h before starting the protocol. End-expiratory lung volume (EELV) and functional residual capacity (FRC) were measured using the nitrogen washout/washin technique. After the procedures in SP, the patients were turned to PP and 1 h later the same procedures were made in PP. Twenty-three patients were included in the study, and twenty were analyzed. The change from SP to PP significantly increased FRC (from 965 ± 397 to 1140 ± 490 ml, p = 0. 008) and EELV (from 1566 ± 476 to 1832 ± 719 ml, p = 0. 008), but PEEP-induced lung volume recruitment did not significantly change (269 ± 186 ml in SP to 324 ± 188 ml in PP, p = 0. 263). Dynamic strain at PEEP decreased with the change from SP to PP (0. 38 ± 0. 14 to 0. 33 ± 0. 13, p = 0. 040). As compared to supine, prone position increases resting lung volumes and decreases dynamic lung strain. The online version of this article (10. 1186/s13613-018-0371-0) contains supplementary material, which is available to authorized users.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	ARDS ; Lung volumes ; Lung strain ; Prone ; PEEP recruitment ; Mechanical ventilation
Published in:	Annals of Intensive Care, Vol. 8 (february 2018) , ISSN 2110-5820

DOI: 10.1186/s13613-018-0371-0
PMID: 29445887

9 p, 1.1 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles