Can the tomographic aspect characteristics of patients presenting with acute respiratory distress syndrome predict improvement in oxygenation-related response to the prone position?
Identifieur interne : 000519 ( Main/Exploration ); précédent : 000518; suivant : 000520Can the tomographic aspect characteristics of patients presenting with acute respiratory distress syndrome predict improvement in oxygenation-related response to the prone position?
Auteurs : Laurent Papazian [France] ; Marie-Héléne Paladini ; Fabienne Bregeon ; Xavier Thirion ; Olivier Durieux ; Marc Gainnier ; Laetitia Huiart ; Serge Agostini ; Jean-Pierre AuffraySource :
- Anesthesiology [ 0003-3022 ] ; 2002.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Coeur (physiopathologie), Décubitus ventral (physiologie), Femelle (MeSH), Gazométrie sanguine (MeSH), Humains (MeSH), Mâle (MeSH), Oxygène (sang), Oxygénothérapie (MeSH), Poumon (imagerie diagnostique), Poumon (physiopathologie), Résultat thérapeutique (MeSH), Sujet âgé (MeSH), Syndrome de détresse respiratoire de l'adulte (imagerie diagnostique), Syndrome de détresse respiratoire de l'adulte (thérapie), Tests de la fonction respiratoire (MeSH), Tomodensitométrie (MeSH), Valeur prédictive des tests (MeSH), Études prospectives (MeSH).
- MESH :
- imagerie diagnostique : Poumon, Syndrome de détresse respiratoire de l'adulte.
- physiologie : Décubitus ventral.
- physiopathologie : Coeur, Poumon.
- sang : Oxygène.
- thérapie : Syndrome de détresse respiratoire de l'adulte.
- Adulte d'âge moyen, Femelle, Gazométrie sanguine, Humains, Mâle, Oxygénothérapie, Résultat thérapeutique, Sujet âgé, Tests de la fonction respiratoire, Tomodensitométrie, Valeur prédictive des tests, Études prospectives.
English descriptors
- KwdEn :
- Aged (MeSH), Blood Gas Analysis (MeSH), Female (MeSH), Heart (physiopathology), Humans (MeSH), Lung (diagnostic imaging), Lung (physiopathology), Male (MeSH), Middle Aged (MeSH), Oxygen (blood), Oxygen Inhalation Therapy (MeSH), Predictive Value of Tests (MeSH), Prone Position (physiology), Prospective Studies (MeSH), Respiratory Distress Syndrome, Adult (diagnostic imaging), Respiratory Distress Syndrome, Adult (therapy), Respiratory Function Tests (MeSH), Tomography, X-Ray Computed (MeSH), Treatment Outcome (MeSH).
- MESH :
- chemical , blood : Oxygen.
- diagnostic imaging : Lung, Respiratory Distress Syndrome, Adult.
- physiology : Prone Position.
- physiopathology : Heart, Lung.
- therapy : Respiratory Distress Syndrome, Adult.
- Aged, Blood Gas Analysis, Female, Humans, Male, Middle Aged, Oxygen Inhalation Therapy, Predictive Value of Tests, Prospective Studies, Respiratory Function Tests, Tomography, X-Ray Computed, Treatment Outcome.
Abstract
BACKGROUND
In some patients with acute respiratory distress syndrome, the prone position is able to improve oxygenation, whereas in others it is not. It could be hypothesized that the more opacities that are present in dependent regions of the lung when the patient is in the supine position, the better the improvement in oxygenation is observed when the patients are turned prone. Therefore, we conducted a prospective study to identify computed tomographic scan aspects that could accurately predict who will respond to the prone position.
METHODS
We included 46 patients with acute respiratory distress syndrome (31 responders and 15 nonresponders). Computed tomographic scan was performed in the 6-h period preceding prone position. Blood gas analyses were performed before and at the end of the first 6-h period of prone position.
RESULTS
Arterial oxygen partial pressure/fraction of inspired oxygen increased from 117 +/- 42 (mean +/- SD) in the supine position to 200 +/- 76 mmHg in the prone position (P < 0.001). There were 31 responders and 15 nonresponders. There was a vertebral predominance of the opacities (P < 0.0001). However, there was no difference between responders and nonresponders. When only the amount of consolidated lung located under the heart was evaluated, there was more consolidated tissue under the heart relative to total lung area in nonresponders than in responders (P = 0.01).
CONCLUSIONS
There are no distinctive morphologic features in the pattern of lung disease measured by computed tomographic scanning performed with the patient in the supine position that can predict response to the prone position.
DOI: 10.1097/00000542-200209000-00013
PubMed: 12218526
Affiliations:
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uniqKey="Paladini M" first="Marie-Héléne" last="Paladini">Marie-Héléne Paladini</name></author><author><name sortKey="Bregeon, Fabienne" sort="Bregeon, Fabienne" uniqKey="Bregeon F" first="Fabienne" last="Bregeon">Fabienne Bregeon</name></author><author><name sortKey="Thirion, Xavier" sort="Thirion, Xavier" uniqKey="Thirion X" first="Xavier" last="Thirion">Xavier Thirion</name></author><author><name sortKey="Durieux, Olivier" sort="Durieux, Olivier" uniqKey="Durieux O" first="Olivier" last="Durieux">Olivier Durieux</name></author><author><name sortKey="Gainnier, Marc" sort="Gainnier, Marc" uniqKey="Gainnier M" first="Marc" last="Gainnier">Marc Gainnier</name></author><author><name sortKey="Huiart, Laetitia" sort="Huiart, Laetitia" uniqKey="Huiart L" first="Laetitia" last="Huiart">Laetitia Huiart</name></author><author><name sortKey="Agostini, Serge" sort="Agostini, Serge" uniqKey="Agostini S" first="Serge" last="Agostini">Serge Agostini</name></author><author><name sortKey="Auffray, 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Laurent" sort="Papazian, Laurent" uniqKey="Papazian L" first="Laurent" last="Papazian">Laurent Papazian</name><affiliation wicri:level="3"><nlm:affiliation>Polyvalent Intenstive Care Unit, Hôpital Sainte-Marguerite, Marseille, France. lpapazian@mail.ap-hm.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Polyvalent Intenstive Care Unit, Hôpital Sainte-Marguerite, Marseille</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Paladini, Marie Helene" sort="Paladini, Marie Helene" uniqKey="Paladini M" first="Marie-Héléne" last="Paladini">Marie-Héléne Paladini</name></author><author><name sortKey="Bregeon, Fabienne" sort="Bregeon, Fabienne" uniqKey="Bregeon F" first="Fabienne" last="Bregeon">Fabienne Bregeon</name></author><author><name sortKey="Thirion, Xavier" sort="Thirion, Xavier" uniqKey="Thirion X" first="Xavier" last="Thirion">Xavier Thirion</name></author><author><name sortKey="Durieux, Olivier" sort="Durieux, Olivier" uniqKey="Durieux O" first="Olivier" last="Durieux">Olivier Durieux</name></author><author><name sortKey="Gainnier, Marc" sort="Gainnier, Marc" uniqKey="Gainnier M" first="Marc" last="Gainnier">Marc Gainnier</name></author><author><name sortKey="Huiart, Laetitia" sort="Huiart, Laetitia" uniqKey="Huiart L" first="Laetitia" last="Huiart">Laetitia Huiart</name></author><author><name sortKey="Agostini, Serge" sort="Agostini, Serge" uniqKey="Agostini S" first="Serge" last="Agostini">Serge Agostini</name></author><author><name sortKey="Auffray, Jean Pierre" sort="Auffray, Jean Pierre" uniqKey="Auffray J" first="Jean-Pierre" last="Auffray">Jean-Pierre Auffray</name></author></analytic><series><title level="j">Anesthesiology</title><idno type="ISSN">0003-3022</idno><imprint><date when="2002" type="published">2002</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Blood Gas Analysis (MeSH)</term><term>Female (MeSH)</term><term>Heart (physiopathology)</term><term>Humans (MeSH)</term><term>Lung (diagnostic imaging)</term><term>Lung (physiopathology)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Oxygen (blood)</term><term>Oxygen Inhalation Therapy (MeSH)</term><term>Predictive Value of Tests (MeSH)</term><term>Prone Position (physiology)</term><term>Prospective Studies (MeSH)</term><term>Respiratory Distress Syndrome, Adult (diagnostic imaging)</term><term>Respiratory Distress Syndrome, Adult (therapy)</term><term>Respiratory Function Tests (MeSH)</term><term>Tomography, X-Ray Computed (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term><term>Coeur (physiopathologie)</term><term>Décubitus ventral (physiologie)</term><term>Femelle (MeSH)</term><term>Gazométrie sanguine (MeSH)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Oxygène (sang)</term><term>Oxygénothérapie (MeSH)</term><term>Poumon (imagerie diagnostique)</term><term>Poumon (physiopathologie)</term><term>Résultat thérapeutique (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Syndrome de détresse respiratoire de l'adulte (imagerie diagnostique)</term><term>Syndrome de détresse respiratoire de l'adulte (thérapie)</term><term>Tests de la fonction respiratoire (MeSH)</term><term>Tomodensitométrie (MeSH)</term><term>Valeur prédictive des tests (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Oxygen</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Lung</term><term>Respiratory Distress Syndrome, Adult</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Poumon</term><term>Syndrome de détresse respiratoire de l'adulte</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Décubitus ventral</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Prone Position</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Coeur</term><term>Poumon</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Heart</term><term>Lung</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Oxygène</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>Aged</term><term>Blood Gas Analysis</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Oxygen Inhalation Therapy</term><term>Predictive Value of Tests</term><term>Prospective Studies</term><term>Respiratory Function Tests</term><term>Tomography, X-Ray Computed</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Gazométrie sanguine</term><term>Humains</term><term>Mâle</term><term>Oxygénothérapie</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Tests de la fonction respiratoire</term><term>Tomodensitométrie</term><term>Valeur prédictive des tests</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>In some patients with acute respiratory distress syndrome, the prone position is able to improve oxygenation, whereas in others it is not. It could be hypothesized that the more opacities that are present in dependent regions of the lung when the patient is in the supine position, the better the improvement in oxygenation is observed when the patients are turned prone. Therefore, we conducted a prospective study to identify computed tomographic scan aspects that could accurately predict who will respond to the prone position.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We included 46 patients with acute respiratory distress syndrome (31 responders and 15 nonresponders). Computed tomographic scan was performed in the 6-h period preceding prone position. Blood gas analyses were performed before and at the end of the first 6-h period of prone position.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Arterial oxygen partial pressure/fraction of inspired oxygen increased from 117 +/- 42 (mean +/- SD) in the supine position to 200 +/- 76 mmHg in the prone position (P < 0.001). There were 31 responders and 15 nonresponders. There was a vertebral predominance of the opacities (P < 0.0001). However, there was no difference between responders and nonresponders. When only the amount of consolidated lung located under the heart was evaluated, there was more consolidated tissue under the heart relative to total lung area in nonresponders than in responders (P = 0.01).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>There are no distinctive morphologic features in the pattern of lung disease measured by computed tomographic scanning performed with the patient in the supine position that can predict response to the prone position.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">12218526</PMID><DateCompleted><Year>2002</Year><Month>09</Month><Day>24</Day></DateCompleted><DateRevised><Year>2019</Year><Month>06</Month><Day>28</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0003-3022</ISSN><JournalIssue CitedMedium="Print"><Volume>97</Volume><Issue>3</Issue><PubDate><Year>2002</Year><Month>Sep</Month></PubDate></JournalIssue><Title>Anesthesiology</Title></Journal><ArticleTitle>Can the tomographic aspect characteristics of patients presenting with acute respiratory distress syndrome predict improvement in oxygenation-related response to the prone position?</ArticleTitle><Pagination><MedlinePgn>599-607</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">In some patients with acute respiratory distress syndrome, the prone position is able to improve oxygenation, whereas in others it is not. It could be hypothesized that the more opacities that are present in dependent regions of the lung when the patient is in the supine position, the better the improvement in oxygenation is observed when the patients are turned prone. Therefore, we conducted a prospective study to identify computed tomographic scan aspects that could accurately predict who will respond to the prone position.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We included 46 patients with acute respiratory distress syndrome (31 responders and 15 nonresponders). Computed tomographic scan was performed in the 6-h period preceding prone position. Blood gas analyses were performed before and at the end of the first 6-h period of prone position.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Arterial oxygen partial pressure/fraction of inspired oxygen increased from 117 +/- 42 (mean +/- SD) in the supine position to 200 +/- 76 mmHg in the prone position (P < 0.001). There were 31 responders and 15 nonresponders. There was a vertebral predominance of the opacities (P < 0.0001). However, there was no difference between responders and nonresponders. When only the amount of consolidated lung located under the heart was evaluated, there was more consolidated tissue under the heart relative to total lung area in nonresponders than in responders (P = 0.01).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">There are no distinctive morphologic features in the pattern of lung disease measured by computed tomographic scanning performed with the patient in the supine position that can predict response to the prone position.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Papazian</LastName><ForeName>Laurent</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Polyvalent Intenstive Care Unit, Hôpital Sainte-Marguerite, Marseille, France. lpapazian@mail.ap-hm.fr</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Paladini</LastName><ForeName>Marie-Héléne</ForeName><Initials>MH</Initials></Author><Author ValidYN="Y"><LastName>Bregeon</LastName><ForeName>Fabienne</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Thirion</LastName><ForeName>Xavier</ForeName><Initials>X</Initials></Author><Author ValidYN="Y"><LastName>Durieux</LastName><ForeName>Olivier</ForeName><Initials>O</Initials></Author><Author ValidYN="Y"><LastName>Gainnier</LastName><ForeName>Marc</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Huiart</LastName><ForeName>Laetitia</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Agostini</LastName><ForeName>Serge</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Auffray</LastName><ForeName>Jean-Pierre</ForeName><Initials>JP</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Anesthesiology</MedlineTA><NlmUniqueID>1300217</NlmUniqueID><ISSNLinking>0003-3022</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>S88TT14065</RegistryNumber><NameOfSubstance UI="D010100">Oxygen</NameOfSubstance></Chemical></ChemicalList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001784" MajorTopicYN="N">Blood Gas Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006321" MajorTopicYN="N">Heart</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008168" MajorTopicYN="N">Lung</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010100" MajorTopicYN="N">Oxygen</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010102" MajorTopicYN="Y">Oxygen Inhalation Therapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011237" MajorTopicYN="N">Predictive Value of Tests</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016684" MajorTopicYN="N">Prone Position</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012128" MajorTopicYN="N">Respiratory Distress Syndrome, Adult</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012129" MajorTopicYN="N">Respiratory Function Tests</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014057" MajorTopicYN="N">Tomography, X-Ray Computed</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2002</Year><Month>9</Month><Day>10</Day><Hour>10</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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Fabienne" sort="Bregeon, Fabienne" uniqKey="Bregeon F" first="Fabienne" last="Bregeon">Fabienne Bregeon</name><name sortKey="Durieux, Olivier" sort="Durieux, Olivier" uniqKey="Durieux O" first="Olivier" last="Durieux">Olivier Durieux</name><name sortKey="Gainnier, Marc" sort="Gainnier, Marc" uniqKey="Gainnier M" first="Marc" last="Gainnier">Marc Gainnier</name><name sortKey="Huiart, Laetitia" sort="Huiart, Laetitia" uniqKey="Huiart L" first="Laetitia" last="Huiart">Laetitia Huiart</name><name sortKey="Paladini, Marie Helene" sort="Paladini, Marie Helene" uniqKey="Paladini M" first="Marie-Héléne" last="Paladini">Marie-Héléne Paladini</name><name sortKey="Thirion, Xavier" sort="Thirion, Xavier" uniqKey="Thirion X" first="Xavier" last="Thirion">Xavier Thirion</name></noCountry><country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Papazian, Laurent" sort="Papazian, Laurent" uniqKey="Papazian L" first="Laurent" last="Papazian">Laurent 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