A prospective survey of early 12-h prone positioning effects in patients with the acute respiratory distress syndrome.
Identifieur interne : 000522 ( Main/Exploration ); précédent : 000521; suivant : 000523A prospective survey of early 12-h prone positioning effects in patients with the acute respiratory distress syndrome.
Auteurs : Erwan L'Her [France] ; Anne Renault ; Emmanuel Oger ; Marie-Aline Robaux ; Jean-Michel BolesSource :
- Intensive care medicine [ 0342-4642 ] ; 2002.
Descripteurs français
- KwdFr :
- Décubitus ventral (MeSH), Femelle (MeSH), Gazométrie sanguine (MeSH), Humains (MeSH), Mâle (MeSH), Respirateurs artificiels (effets indésirables), Résultat thérapeutique (MeSH), Statistique non paramétrique (MeSH), Syndrome de détresse respiratoire de l'adulte (sang), Syndrome de détresse respiratoire de l'adulte (thérapie), Études prospectives (MeSH).
- MESH :
- effets indésirables : Respirateurs artificiels.
- sang : Syndrome de détresse respiratoire de l'adulte.
- thérapie : Syndrome de détresse respiratoire de l'adulte.
- Décubitus ventral, Femelle, Gazométrie sanguine, Humains, Mâle, Résultat thérapeutique, Statistique non paramétrique, Études prospectives.
English descriptors
- KwdEn :
- Blood Gas Analysis (MeSH), Female (MeSH), Humans (MeSH), Male (MeSH), Prone Position (MeSH), Prospective Studies (MeSH), Respiratory Distress Syndrome, Adult (blood), Respiratory Distress Syndrome, Adult (therapy), Statistics, Nonparametric (MeSH), Treatment Outcome (MeSH), Ventilators, Mechanical (adverse effects).
- MESH :
- adverse effects : Ventilators, Mechanical.
- blood : Respiratory Distress Syndrome, Adult.
- therapy : Respiratory Distress Syndrome, Adult.
- Blood Gas Analysis, Female, Humans, Male, Prone Position, Prospective Studies, Statistics, Nonparametric, Treatment Outcome.
Abstract
OBJECTIVES
To evaluate of the oxygenation effects of 12-h prone positioning (PP) in ARDS patients and to assess the safety of such a procedure.
DESIGN AND SETTING
Prospective observational study in a medical intensive care unit (12 beds) of a university hospital.
PATIENTS
51 consecutive ARDS patients.
INTERVENTION
PP for at least 12 h daily until recovery or death.
MEASUREMENTS AND RESULTS
Arterial blood gases were collected before and during PP and 1 h after return to supine. Turning adverse events, cutaneous bedsores, and enteral nutrition intolerance were specifically monitored and collected daily by a referring physician. In total 224 PP sessions were performed. Oxygenation improved 1 h after the turn and continued improving over the 12-h period (4). The beneficial effect persisted 1 h after return to supine (01). We considered 96% patients responders: 45% as early responders and 53% persistent responders (persistent benefit after return to supine). Four significant adverse events occurred during the 448 turning maneuvers (0.9%). Stage III ulceration and stage IV necrosis cutaneous bedsores occurred in ten patients (20%). Enteral nutrition intolerance was reported in 25% but without inability to meet patient's caloric requirement.
CONCLUSIONS
Twelve-hour PP is a safe procedure and allows a continuous oxygenation improvement throughout the entire session.
DOI: 10.1007/s00134-002-1258-x
PubMed: 12029404
Affiliations:
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sort="Oger, Emmanuel" uniqKey="Oger E" first="Emmanuel" last="Oger">Emmanuel Oger</name></author><author><name sortKey="Robaux, Marie Aline" sort="Robaux, Marie Aline" uniqKey="Robaux M" first="Marie-Aline" last="Robaux">Marie-Aline Robaux</name></author><author><name sortKey="Boles, Jean Michel" sort="Boles, Jean Michel" uniqKey="Boles J" first="Jean-Michel" last="Boles">Jean-Michel Boles</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2002">2002</date><idno type="RBID">pubmed:12029404</idno><idno type="pmid">12029404</idno><idno type="doi">10.1007/s00134-002-1258-x</idno><idno type="wicri:Area/Main/Corpus">000513</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000513</idno><idno type="wicri:Area/Main/Curation">000513</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000513</idno><idno type="wicri:Area/Main/Exploration">000513</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">A prospective survey of early 12-h prone positioning effects in patients with the acute respiratory distress syndrome.</title><author><name sortKey="L Her, Erwan" sort="L Her, Erwan" uniqKey="L Her E" first="Erwan" last="L'Her">Erwan L'Her</name><affiliation wicri:level="3"><nlm:affiliation>Réanimation et Urgences Médicales, CHU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France. elher@univ-brest.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Réanimation et Urgences Médicales, CHU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex</wicri:regionArea><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Brest</settlement></placeName></affiliation></author><author><name sortKey="Renault, Anne" sort="Renault, Anne" uniqKey="Renault A" first="Anne" last="Renault">Anne Renault</name></author><author><name sortKey="Oger, Emmanuel" sort="Oger, Emmanuel" uniqKey="Oger E" first="Emmanuel" last="Oger">Emmanuel Oger</name></author><author><name sortKey="Robaux, Marie Aline" sort="Robaux, Marie Aline" uniqKey="Robaux M" first="Marie-Aline" last="Robaux">Marie-Aline Robaux</name></author><author><name sortKey="Boles, Jean Michel" sort="Boles, Jean Michel" uniqKey="Boles J" first="Jean-Michel" last="Boles">Jean-Michel Boles</name></author></analytic><series><title level="j">Intensive care medicine</title><idno type="ISSN">0342-4642</idno><imprint><date when="2002" type="published">2002</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Blood Gas Analysis (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Prone Position (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Respiratory Distress Syndrome, Adult (blood)</term><term>Respiratory Distress Syndrome, Adult (therapy)</term><term>Statistics, Nonparametric (MeSH)</term><term>Treatment Outcome (MeSH)</term><term>Ventilators, Mechanical (adverse effects)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Décubitus ventral (MeSH)</term><term>Femelle (MeSH)</term><term>Gazométrie sanguine (MeSH)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Respirateurs artificiels (effets indésirables)</term><term>Résultat thérapeutique (MeSH)</term><term>Statistique non paramétrique (MeSH)</term><term>Syndrome de détresse respiratoire de l'adulte (sang)</term><term>Syndrome de détresse respiratoire de l'adulte (thérapie)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Ventilators, Mechanical</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Respiratory Distress Syndrome, Adult</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Respirateurs artificiels</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Syndrome de détresse respiratoire de l'adulte</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>Blood Gas Analysis</term><term>Female</term><term>Humans</term><term>Male</term><term>Prone Position</term><term>Prospective Studies</term><term>Statistics, Nonparametric</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Décubitus ventral</term><term>Femelle</term><term>Gazométrie sanguine</term><term>Humains</term><term>Mâle</term><term>Résultat thérapeutique</term><term>Statistique non paramétrique</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>To evaluate of the oxygenation effects of 12-h prone positioning (PP) in ARDS patients and to assess the safety of such a procedure.</p></div><div type="abstract" xml:lang="en"><p><b>DESIGN AND SETTING</b></p><p>Prospective observational study in a medical intensive care unit (12 beds) of a university hospital.</p></div><div type="abstract" xml:lang="en"><p><b>PATIENTS</b></p><p>51 consecutive ARDS patients.</p></div><div type="abstract" xml:lang="en"><p><b>INTERVENTION</b></p><p>PP for at least 12 h daily until recovery or death.</p></div><div type="abstract" xml:lang="en"><p><b>MEASUREMENTS AND RESULTS</b></p><p>Arterial blood gases were collected before and during PP and 1 h after return to supine. Turning adverse events, cutaneous bedsores, and enteral nutrition intolerance were specifically monitored and collected daily by a referring physician. In total 224 PP sessions were performed. Oxygenation improved 1 h after the turn and continued improving over the 12-h period (4). The beneficial effect persisted 1 h after return to supine (01). We considered 96% patients responders: 45% as early responders and 53% persistent responders (persistent benefit after return to supine). Four significant adverse events occurred during the 448 turning maneuvers (0.9%). Stage III ulceration and stage IV necrosis cutaneous bedsores occurred in ten patients (20%). Enteral nutrition intolerance was reported in 25% but without inability to meet patient's caloric requirement.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Twelve-hour PP is a safe procedure and allows a continuous oxygenation improvement throughout the entire session.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">12029404</PMID><DateCompleted><Year>2002</Year><Month>10</Month><Day>02</Day></DateCompleted><DateRevised><Year>2004</Year><Month>11</Month><Day>17</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">0342-4642</ISSN><JournalIssue CitedMedium="Print"><Volume>28</Volume><Issue>5</Issue><PubDate><Year>2002</Year><Month>May</Month></PubDate></JournalIssue><Title>Intensive care medicine</Title></Journal><ArticleTitle>A prospective survey of early 12-h prone positioning effects in patients with the acute respiratory distress syndrome.</ArticleTitle><Pagination><MedlinePgn>570-5</MedlinePgn></Pagination><Abstract><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To evaluate of the oxygenation effects of 12-h prone positioning (PP) in ARDS patients and to assess the safety of such a procedure.</AbstractText><AbstractText Label="DESIGN AND SETTING" NlmCategory="METHODS">Prospective observational study in a medical intensive care unit (12 beds) of a university hospital.</AbstractText><AbstractText Label="PATIENTS" NlmCategory="METHODS">51 consecutive ARDS patients.</AbstractText><AbstractText Label="INTERVENTION" NlmCategory="METHODS">PP for at least 12 h daily until recovery or death.</AbstractText><AbstractText Label="MEASUREMENTS AND RESULTS" NlmCategory="RESULTS">Arterial blood gases were collected before and during PP and 1 h after return to supine. Turning adverse events, cutaneous bedsores, and enteral nutrition intolerance were specifically monitored and collected daily by a referring physician. In total 224 PP sessions were performed. Oxygenation improved 1 h after the turn and continued improving over the 12-h period (4). The beneficial effect persisted 1 h after return to supine (01). We considered 96% patients responders: 45% as early responders and 53% persistent responders (persistent benefit after return to supine). Four significant adverse events occurred during the 448 turning maneuvers (0.9%). Stage III ulceration and stage IV necrosis cutaneous bedsores occurred in ten patients (20%). Enteral nutrition intolerance was reported in 25% but without inability to meet patient's caloric requirement.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Twelve-hour PP is a safe procedure and allows a continuous oxygenation improvement throughout the entire session.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>L'Her</LastName><ForeName>Erwan</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Réanimation et Urgences Médicales, CHU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France. elher@univ-brest.fr</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Renault</LastName><ForeName>Anne</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Oger</LastName><ForeName>Emmanuel</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Robaux</LastName><ForeName>Marie-Aline</ForeName><Initials>MA</Initials></Author><Author ValidYN="Y"><LastName>Boles</LastName><ForeName>Jean-Michel</ForeName><Initials>JM</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2002</Year><Month>03</Month><Day>27</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Intensive Care Med</MedlineTA><NlmUniqueID>7704851</NlmUniqueID><ISSNLinking>0342-4642</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D001784" MajorTopicYN="N">Blood Gas Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016684" MajorTopicYN="Y">Prone Position</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012128" MajorTopicYN="N">Respiratory Distress Syndrome, Adult</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018709" MajorTopicYN="N">Statistics, Nonparametric</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012122" MajorTopicYN="N">Ventilators, Mechanical</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2001</Year><Month>09</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2002</Year><Month>02</Month><Day>05</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2002</Year><Month>5</Month><Day>25</Day><Hour>10</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2002</Year><Month>10</Month><Day>3</Day><Hour>4</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2002</Year><Month>5</Month><Day>25</Day><Hour>10</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">12029404</ArticleId><ArticleId IdType="doi">10.1007/s00134-002-1258-x</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>France</li></country><region><li>Région Bretagne</li></region><settlement><li>Brest</li></settlement></list><tree><noCountry><name sortKey="Boles, Jean Michel" sort="Boles, Jean Michel" uniqKey="Boles J" first="Jean-Michel" last="Boles">Jean-Michel Boles</name><name sortKey="Oger, Emmanuel" sort="Oger, Emmanuel" uniqKey="Oger E" first="Emmanuel" last="Oger">Emmanuel Oger</name><name sortKey="Renault, Anne" sort="Renault, Anne" uniqKey="Renault A" first="Anne" last="Renault">Anne Renault</name><name sortKey="Robaux, Marie Aline" sort="Robaux, Marie Aline" uniqKey="Robaux M" first="Marie-Aline" last="Robaux">Marie-Aline Robaux</name></noCountry><country name="France"><region name="Région Bretagne"><name sortKey="L Her, Erwan" sort="L Her, Erwan" uniqKey="L Her E" first="Erwan" last="L'Her">Erwan L'Her</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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