Ventilation in the prone position in patients with acute lung injury/acute respiratory distress syndrome.
Identifieur interne : 000386 ( Main/Exploration ); précédent : 000385; suivant : 000387Ventilation in the prone position in patients with acute lung injury/acute respiratory distress syndrome.
Auteurs : Claude Guérin [France]Source :
- Current opinion in critical care [ 1070-5295 ] ; 2006.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
Abstract
PURPOSE OF REVIEW
To contrast the beneficial effects of the prone position on the lungs and the lack of proven clinical benefits on patient outcome.
RECENT FINDINGS
Recent human investigations in acute respiratory distress syndrome have shown that the prone position was able to abolish tidal expiratory flow limitation, to improve oxygenation in the case of localized infiltrates, to allow for reducing positive end-expiratory pressure level, and to reduce lung stress and strain. Experimental studies have confirmed that distribution of ventilation was more homogeneous in the prone position but showed that positive end-expiratory pressure affected ventilation distribution differently in the prone and in the supine position. Experimental work has also shown that proning reduced strains imposed on the lungs and made them more homogeneously distributed. Finally, one recent large randomized controlled trial of systematic proning in hypoxemic patients showed no reduction in mortality but less ventilator-associated pneumonia incidence in the prone position group.
SUMMARY
The prone position is not systematically used in hypoxemic patients. Patients who could benefit from prone position sessions are those with the most severe acute respiratory distress syndrome and those with dorsal lung infiltrates. Whether this can be translated into improvement in patient outcome has yet to be tested in clinical trials.
DOI: 10.1097/01.ccx.0000198999.11770.58
PubMed: 16394784
Affiliations:
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type="wicri:source">PubMed</idno><date when="2006">2006</date><idno type="RBID">pubmed:16394784</idno><idno type="pmid">16394784</idno><idno type="doi">10.1097/01.ccx.0000198999.11770.58</idno><idno type="wicri:Area/Main/Corpus">000403</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000403</idno><idno type="wicri:Area/Main/Curation">000403</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000403</idno><idno type="wicri:Area/Main/Exploration">000403</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Ventilation in the prone position in patients with acute lung injury/acute respiratory distress syndrome.</title><author><name sortKey="Guerin, Claude" sort="Guerin, Claude" uniqKey="Guerin C" first="Claude" last="Guérin">Claude Guérin</name><affiliation wicri:level="3"><nlm:affiliation>Medical Intensive Care Unit and Ventilatory Assistance and CREATIS, Research and Applications Center in Image and Signal Processing, Lyon, France. claude.guerin@chu-lyon.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Medical Intensive Care Unit and Ventilatory Assistance and CREATIS, Research and Applications Center in Image and Signal Processing, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author></analytic><series><title level="j">Current opinion in critical care</title><idno type="ISSN">1070-5295</idno><imprint><date when="2006" type="published">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Critical Care (MeSH)</term><term>Humans (MeSH)</term><term>Perfusion (MeSH)</term><term>Prone Position (MeSH)</term><term>Randomized Controlled Trials as Topic (MeSH)</term><term>Respiration, Artificial (methods)</term><term>Respiratory Distress Syndrome, Adult (therapy)</term><term>Respiratory Mechanics (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Décubitus ventral (MeSH)</term><term>Essais contrôlés randomisés comme sujet (MeSH)</term><term>Humains (MeSH)</term><term>Mécanique respiratoire (MeSH)</term><term>Perfusion (MeSH)</term><term>Résultat thérapeutique (MeSH)</term><term>Soins de réanimation (MeSH)</term><term>Syndrome de détresse respiratoire de l'adulte (thérapie)</term><term>Ventilation artificielle (méthodes)</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Respiration, Artificial</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Ventilation artificielle</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Respiratory Distress Syndrome, Adult</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Syndrome de détresse respiratoire de l'adulte</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Critical Care</term><term>Humans</term><term>Perfusion</term><term>Prone Position</term><term>Randomized Controlled Trials as Topic</term><term>Respiratory Mechanics</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Décubitus ventral</term><term>Essais contrôlés randomisés comme sujet</term><term>Humains</term><term>Mécanique respiratoire</term><term>Perfusion</term><term>Résultat thérapeutique</term><term>Soins de réanimation</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>PURPOSE OF REVIEW</b></p><p>To contrast the beneficial effects of the prone position on the lungs and the lack of proven clinical benefits on patient outcome.</p></div><div type="abstract" xml:lang="en"><p><b>RECENT FINDINGS</b></p><p>Recent human investigations in acute respiratory distress syndrome have shown that the prone position was able to abolish tidal expiratory flow limitation, to improve oxygenation in the case of localized infiltrates, to allow for reducing positive end-expiratory pressure level, and to reduce lung stress and strain. Experimental studies have confirmed that distribution of ventilation was more homogeneous in the prone position but showed that positive end-expiratory pressure affected ventilation distribution differently in the prone and in the supine position. Experimental work has also shown that proning reduced strains imposed on the lungs and made them more homogeneously distributed. Finally, one recent large randomized controlled trial of systematic proning in hypoxemic patients showed no reduction in mortality but less ventilator-associated pneumonia incidence in the prone position group.</p></div><div type="abstract" xml:lang="en"><p><b>SUMMARY</b></p><p>The prone position is not systematically used in hypoxemic patients. Patients who could benefit from prone position sessions are those with the most severe acute respiratory distress syndrome and those with dorsal lung infiltrates. Whether this can be translated into improvement in patient outcome has yet to be tested in clinical trials.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">16394784</PMID><DateCompleted><Year>2006</Year><Month>07</Month><Day>13</Day></DateCompleted><DateRevised><Year>2019</Year><Month>11</Month><Day>09</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1070-5295</ISSN><JournalIssue CitedMedium="Print"><Volume>12</Volume><Issue>1</Issue><PubDate><Year>2006</Year><Month>Feb</Month></PubDate></JournalIssue><Title>Current opinion in critical care</Title></Journal><ArticleTitle>Ventilation in the prone position in patients with acute lung injury/acute respiratory distress syndrome.</ArticleTitle><Pagination><MedlinePgn>50-4</MedlinePgn></Pagination><Abstract><AbstractText Label="PURPOSE OF REVIEW" NlmCategory="OBJECTIVE">To contrast the beneficial effects of the prone position on the lungs and the lack of proven clinical benefits on patient outcome.</AbstractText><AbstractText Label="RECENT FINDINGS" NlmCategory="RESULTS">Recent human investigations in acute respiratory distress syndrome have shown that the prone position was able to abolish tidal expiratory flow limitation, to improve oxygenation in the case of localized infiltrates, to allow for reducing positive end-expiratory pressure level, and to reduce lung stress and strain. Experimental studies have confirmed that distribution of ventilation was more homogeneous in the prone position but showed that positive end-expiratory pressure affected ventilation distribution differently in the prone and in the supine position. Experimental work has also shown that proning reduced strains imposed on the lungs and made them more homogeneously distributed. Finally, one recent large randomized controlled trial of systematic proning in hypoxemic patients showed no reduction in mortality but less ventilator-associated pneumonia incidence in the prone position group.</AbstractText><AbstractText Label="SUMMARY" NlmCategory="CONCLUSIONS">The prone position is not systematically used in hypoxemic patients. Patients who could benefit from prone position sessions are those with the most severe acute respiratory distress syndrome and those with dorsal lung infiltrates. Whether this can be translated into improvement in patient outcome has yet to be tested in clinical trials.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Guérin</LastName><ForeName>Claude</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Medical Intensive Care Unit and Ventilatory Assistance and CREATIS, Research and Applications Center in Image and Signal Processing, Lyon, France. claude.guerin@chu-lyon.fr</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Curr Opin Crit Care</MedlineTA><NlmUniqueID>9504454</NlmUniqueID><ISSNLinking>1070-5295</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D003422" MajorTopicYN="N">Critical Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010477" MajorTopicYN="N">Perfusion</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016684" MajorTopicYN="Y">Prone Position</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016032" MajorTopicYN="N">Randomized Controlled Trials as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012128" MajorTopicYN="N">Respiratory Distress Syndrome, Adult</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015656" MajorTopicYN="N">Respiratory Mechanics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><NumberOfReferences>19</NumberOfReferences></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2006</Year><Month>1</Month><Day>6</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2006</Year><Month>7</Month><Day>14</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2006</Year><Month>1</Month><Day>6</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">16394784</ArticleId><ArticleId IdType="pii">00075198-200602000-00011</ArticleId><ArticleId IdType="doi">10.1097/01.ccx.0000198999.11770.58</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>France</li></country><region><li>Auvergne-Rhône-Alpes</li><li>Rhône-Alpes</li></region><settlement><li>Lyon</li></settlement></list><tree><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Guerin, Claude" sort="Guerin, Claude" uniqKey="Guerin C" first="Claude" last="Guérin">Claude Guérin</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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