J Wang1, F M Abu-Zidan, S M Walther. 1. Section of Disaster Medicine, Department of Biomedicine and Surgery, Faculty of Health Sciences, University of Linköping, Cardiothoracic Intensive Care Unit, University Hospital, Linköping, Sweden. jiwa@ibk.liu.se
Abstract
BACKGROUND: Chlorine gas may induce severe acute lung injury. Improvement of pulmonary gas exchange in patients and animals with acute lung injury nursed in the prone position was observed in recent years. The purpose of this study was to evaluate the effects of prone and supine positions on pulmonary and cardiovascular functions following experimental chlorine gas lung injury. METHODS: Twenty anesthetized and mechanically ventilated pigs were exposed to chlorine gas (400 p.p.m. in air) for 20 min in the supine position, then assigned randomly to ventilation in the supine or prone positions (n=10 in each group). Hemodynamics, gas exchange, lung mechanics and oxygen transport were evaluated for 5 h. RESULTS: All animals showed severe pulmonary dysfunction immediately after chlorine gassing with a threefold increase in pulmonary vascular resistance index, a drop in arterial oxygenation (12.3+/-1.3 kPa to 5.4+/-0.7 kPa) and a fall in lung-thorax compliance (22+/-1 ml cmH2O-1 to 8+/-2 ml cmH2O-1). Venous admixture (Qs/Qt) improved in animals in the prone position while there was no change in the supine position (prone 32+/-11% vs. supine 42+/-9% at 5 h,P<0.05). Lung-thorax compliance improved significantly with time in the prone group only (P<0.01). Oxygen delivery increased significantly in prone animals compared with animals nursed in the supine posture (P<0.001). CONCLUSION: Immediate prone positioning after chlorine gas injury not only inhibited deterioration of gas exchange but was also associated with improved pulmonary function and oxygen transport.
BACKGROUND:Chlorine gas may induce severe acute lung injury. Improvement of pulmonary gas exchange in patients and animals with acute lung injury nursed in the prone position was observed in recent years. The purpose of this study was to evaluate the effects of prone and supine positions on pulmonary and cardiovascular functions following experimental chlorinegas lung injury. METHODS: Twenty anesthetized and mechanically ventilated pigs were exposed to chlorine gas (400 p.p.m. in air) for 20 min in the supine position, then assigned randomly to ventilation in the supine or prone positions (n=10 in each group). Hemodynamics, gas exchange, lung mechanics and oxygen transport were evaluated for 5 h. RESULTS: All animals showed severe pulmonary dysfunction immediately after chlorine gassing with a threefold increase in pulmonary vascular resistance index, a drop in arterial oxygenation (12.3+/-1.3 kPa to 5.4+/-0.7 kPa) and a fall in lung-thorax compliance (22+/-1 ml cmH2O-1 to 8+/-2 ml cmH2O-1). Venous admixture (Qs/Qt) improved in animals in the prone position while there was no change in the supine position (prone 32+/-11% vs. supine 42+/-9% at 5 h,P<0.05). Lung-thorax compliance improved significantly with time in the prone group only (P<0.01). Oxygen delivery increased significantly in prone animals compared with animals nursed in the supine posture (P<0.001). CONCLUSION: Immediate prone positioning after chlorinegas injury not only inhibited deterioration of gas exchange but was also associated with improved pulmonary function and oxygen transport.
Authors: Shama Ahmad; Aftab Ahmad; Tara B Hendry-Hofer; Joan E Loader; William C Claycomb; Olivier Mozziconacci; Christian Schöneich; Nichole Reisdorph; Roger L Powell; Joshua D Chandler; Brian J Day; Livia A Veress; Carl W White Journal: Am J Respir Cell Mol Biol Date: 2015-04 Impact factor: 6.914
Authors: Ahmed Zaky; Aftab Ahmad; Louis J Dell'Italia; Leila Jahromi; Lee Ann Reisenberg; Sadis Matalon; Shama Ahmad Journal: Cardiovasc Regen Med Date: 2015-09-20
Authors: Ahmed Zaky; Wayne E Bradley; Ahmed Lazrak; Iram Zafar; Stephen Doran; Aftab Ahmad; Carl W White; Louis J Dell'Italia; Sadis Matalon; Shama Ahmad Journal: Physiol Rep Date: 2015-06