BACKGROUND/ PURPOSE: Acute respiratory distress syndrome (ARDS) is a serious disorder of intensive care unit patients. We evaluated the safety of continuous prone position ventilation (PRONE) and its effects on oxygenation and plasma cytokine concentrations in patients with ARDS caused by severe community-acquired pneumonia (CAP). METHODS: This was a prospective observational clinical study conducted in a respiratory intensive care unit of a 1200-bed medical center in central Taiwan. Twenty-two patients with severe CAP and ARDS were included. They were treated by traditional supine ventilation (SUPINE, n = 11) or PRONE (n = 11) if they met the criteria for ARDS. Patients in the PRONE group were ventilated in prone position continuously for at least 72 hours. Plasma cytokines were collected and analyzed at baseline, 24 hours and 72 hours after enrolment. Serial PaO2/FiO2 and complications were evaluated. RESULTS: Complications associated with PRONE were minor and self-limited. PRONE had higher PaO2/FiO2 ratio than SUPINE did at 48 hours after enrolment. The levels of plasma IL-6 concentration declined significantly with time in the PRONE group (p = 0.011). The levels of plasma IL-6 concentration at enrolment, 24 hours and 72 hours after enrolment also predicted the 14th day mortality of all patients. CONCLUSION: PRONE was a safe and effective maneuver for improving oxygenation in patients with severe CAP and ARDS. PRONE also influenced IL-6 expression in patients with severe CAP.
BACKGROUND/ PURPOSE: Acute respiratory distress syndrome (ARDS) is a serious disorder of intensive care unit patients. We evaluated the safety of continuous prone position ventilation (PRONE) and its effects on oxygenation and plasma cytokine concentrations in patients with ARDS caused by severe community-acquired pneumonia (CAP). METHODS: This was a prospective observational clinical study conducted in a respiratory intensive care unit of a 1200-bed medical center in central Taiwan. Twenty-two patients with severe CAP and ARDS were included. They were treated by traditional supine ventilation (SUPINE, n = 11) or PRONE (n = 11) if they met the criteria for ARDS. Patients in the PRONE group were ventilated in prone position continuously for at least 72 hours. Plasma cytokines were collected and analyzed at baseline, 24 hours and 72 hours after enrolment. Serial PaO2/FiO2 and complications were evaluated. RESULTS: Complications associated with PRONE were minor and self-limited. PRONE had higher PaO2/FiO2 ratio than SUPINE did at 48 hours after enrolment. The levels of plasma IL-6 concentration declined significantly with time in the PRONE group (p = 0.011). The levels of plasma IL-6 concentration at enrolment, 24 hours and 72 hours after enrolment also predicted the 14th day mortality of all patients. CONCLUSION: PRONE was a safe and effective maneuver for improving oxygenation in patients with severe CAP and ARDS. PRONE also influenced IL-6 expression in patients with severe CAP.
Authors: Raphaele Girard; Loredana Baboi; Louis Ayzac; Jean-Christophe Richard; Claude Guérin Journal: Intensive Care Med Date: 2013-12-19 Impact factor: 17.440
Authors: Sachin Sud; Jan O Friedrich; Paolo Taccone; Federico Polli; Neill K J Adhikari; Roberto Latini; Antonio Pesenti; Claude Guérin; Jordi Mancebo; Martha A Q Curley; Rafael Fernandez; Ming-Cheng Chan; Pascal Beuret; Gregor Voggenreiter; Maneesh Sud; Gianni Tognoni; Luciano Gattinoni Journal: Intensive Care Med Date: 2010-02-04 Impact factor: 17.440
Authors: Jeremy R Beitler; Shahzad Shaefi; Sydney B Montesi; Amy Devlin; Stephen H Loring; Daniel Talmor; Atul Malhotra Journal: Intensive Care Med Date: 2014-01-17 Impact factor: 17.440
Authors: Andrew W Kirkpatrick; Paolo Pelosi; Jan J De Waele; Manu Lng Malbrain; Chad G Ball; Maureen O Meade; Henry T Stelfox; Kevin B Laupland Journal: Crit Care Date: 2010-08-27 Impact factor: 9.097