Comparison of prone positioning and continuous rotation of patients with adult respiratory distress syndrome: results of a pilot study.
Identifieur interne : 000540 ( Main/Exploration ); précédent : 000539; suivant : 000541Comparison of prone positioning and continuous rotation of patients with adult respiratory distress syndrome: results of a pilot study.
Auteurs : T. Staudinger [Autriche] ; J. Kofler ; M. Müllner ; G J Locker ; K. Laczika ; S. Knapp ; H. Losert ; M. FrassSource :
- Critical care medicine [ 0090-3493 ] ; 2001.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Courbe ROC (MeSH), Décubitus ventral (MeSH), Femelle (MeSH), Humains (MeSH), Hémodynamique (MeSH), Monoxyde d'azote (usage thérapeutique), Mâle (MeSH), Projets pilotes (MeSH), Rotation (MeSH), Statistique non paramétrique (MeSH), Sujet âgé (MeSH), Syndrome de détresse respiratoire de l'adulte (thérapie), Ventilation artificielle (MeSH), Échanges gazeux pulmonaires (MeSH), Études prospectives (MeSH).
- MESH :
- thérapie : Syndrome de détresse respiratoire de l'adulte.
- usage thérapeutique : Monoxyde d'azote.
- Adulte, Adulte d'âge moyen, Courbe ROC, Décubitus ventral, Femelle, Humains, Hémodynamique, Mâle, Projets pilotes, Rotation, Statistique non paramétrique, Sujet âgé, Ventilation artificielle, Échanges gazeux pulmonaires, Études prospectives.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Female (MeSH), Hemodynamics (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Nitric Oxide (therapeutic use), Pilot Projects (MeSH), Prone Position (MeSH), Prospective Studies (MeSH), Pulmonary Gas Exchange (MeSH), ROC Curve (MeSH), Respiration, Artificial (MeSH), Respiratory Distress Syndrome, Adult (therapy), Rotation (MeSH), Statistics, Nonparametric (MeSH).
- MESH :
- chemical , therapeutic use : Nitric Oxide.
- therapy : Respiratory Distress Syndrome, Adult.
- Adult, Aged, Female, Hemodynamics, Humans, Male, Middle Aged, Pilot Projects, Prone Position, Prospective Studies, Pulmonary Gas Exchange, ROC Curve, Respiration, Artificial, Rotation, Statistics, Nonparametric.
Abstract
OBJECTIVE
To compare prone positioning and continuous rotational therapy with respect to oxygenation and hemodynamics in patients suffering from adult respiratory distress syndrome (ARDS).
DESIGN
Randomized, prospective pilot study.
SETTING
Intensive care unit at a university hospital.
PATIENTS
Twenty-six mechanically ventilated patients with ARDS from nontraumatic causes.
INTERVENTIONS
Twelve patients were turned prone (group 1), 14 patients underwent continuous axial rotation from one lateral position to the other with a maximum angle of 124 degrees in specially designed beds (group 2). All patients had received inhaled nitric oxide (NO) therapy before positioning.
MEASUREMENTS AND MAIN RESULTS
Gas exchange and hemodynamics were assessed using a pulmonary artery catheter. In both groups, an improvement in PaO2/RFIO2-ratio and intrapulmonary shunt fraction occurred after initiation of NO as well as during the first 72 hrs of positioning therapy. During the study period, seven patients died in group 1 and nine patients in group 2 (p = NS). Comparing the areas under the curve during the first 72 hrs, no significant differences with respect to PaO2/FIO2-ratio, PaCO2, positive end-expiratory and peak inspiratory pressure levels, intrapulmonary shunt fraction, the alveolar-arterial oxygen difference, and oxygen delivery and consumption, as well as cardiac index, pulmonary and arterial blood pressures, and pulmonary arterial occlusion pressure could be detected between the groups. Prone positioning was tolerated well, continuous rotational therapy had to be modified according to hemodynamic instability in three patients.
CONCLUSIONS
In severe lung injury, continuous rotational therapy seems to exert effects comparable to prone positioning and could serve as alternative when prone positioning seems inadvisable.
DOI: 10.1097/00003246-200101000-00014
PubMed: 11176160
Affiliations:
Links toward previous steps (curation, corpus...)
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Müllner</name></author><author><name sortKey="Locker, G J" sort="Locker, G J" uniqKey="Locker G" first="G J" last="Locker">G J Locker</name></author><author><name sortKey="Laczika, K" sort="Laczika, K" uniqKey="Laczika K" first="K" last="Laczika">K. Laczika</name></author><author><name sortKey="Knapp, S" sort="Knapp, S" uniqKey="Knapp S" first="S" last="Knapp">S. Knapp</name></author><author><name sortKey="Losert, H" sort="Losert, H" uniqKey="Losert H" first="H" last="Losert">H. Losert</name></author><author><name sortKey="Frass, M" sort="Frass, M" uniqKey="Frass M" first="M" last="Frass">M. Frass</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2001">2001</date><idno type="RBID">pubmed:11176160</idno><idno type="pmid">11176160</idno><idno type="doi">10.1097/00003246-200101000-00014</idno><idno type="wicri:Area/Main/Corpus">000551</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000551</idno><idno type="wicri:Area/Main/Curation">000551</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000551</idno><idno type="wicri:Area/Main/Exploration">000551</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Comparison of prone positioning and continuous rotation of patients with adult respiratory distress syndrome: results of a pilot study.</title><author><name sortKey="Staudinger, T" sort="Staudinger, T" uniqKey="Staudinger T" first="T" last="Staudinger">T. Staudinger</name><affiliation wicri:level="1"><nlm:affiliation>Department of Internal Medicine I, University of Vienna, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Internal Medicine I, University of Vienna</wicri:regionArea><wicri:noRegion>University of Vienna</wicri:noRegion></affiliation></author><author><name sortKey="Kofler, J" sort="Kofler, J" uniqKey="Kofler J" first="J" last="Kofler">J. Kofler</name></author><author><name sortKey="Mullner, M" sort="Mullner, M" uniqKey="Mullner M" first="M" last="Müllner">M. Müllner</name></author><author><name sortKey="Locker, G J" sort="Locker, G J" uniqKey="Locker G" first="G J" last="Locker">G J Locker</name></author><author><name sortKey="Laczika, K" sort="Laczika, K" uniqKey="Laczika K" first="K" last="Laczika">K. Laczika</name></author><author><name sortKey="Knapp, S" sort="Knapp, S" uniqKey="Knapp S" first="S" last="Knapp">S. Knapp</name></author><author><name sortKey="Losert, H" sort="Losert, H" uniqKey="Losert H" first="H" last="Losert">H. Losert</name></author><author><name sortKey="Frass, M" sort="Frass, M" uniqKey="Frass M" first="M" last="Frass">M. Frass</name></author></analytic><series><title level="j">Critical care medicine</title><idno type="ISSN">0090-3493</idno><imprint><date when="2001" type="published">2001</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Female (MeSH)</term><term>Hemodynamics (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Nitric Oxide (therapeutic use)</term><term>Pilot Projects (MeSH)</term><term>Prone Position (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Pulmonary Gas Exchange (MeSH)</term><term>ROC Curve (MeSH)</term><term>Respiration, Artificial (MeSH)</term><term>Respiratory Distress Syndrome, Adult (therapy)</term><term>Rotation (MeSH)</term><term>Statistics, Nonparametric (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Courbe ROC (MeSH)</term><term>Décubitus ventral (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Hémodynamique (MeSH)</term><term>Monoxyde d'azote (usage thérapeutique)</term><term>Mâle (MeSH)</term><term>Projets pilotes (MeSH)</term><term>Rotation (MeSH)</term><term>Statistique non paramétrique (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Syndrome de détresse respiratoire de l'adulte (thérapie)</term><term>Ventilation artificielle (MeSH)</term><term>Échanges gazeux pulmonaires (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Nitric Oxide</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" qualifier="usage thérapeutique" xml:lang="fr"><term>Monoxyde d'azote</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Hemodynamics</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pilot Projects</term><term>Prone Position</term><term>Prospective Studies</term><term>Pulmonary Gas Exchange</term><term>ROC Curve</term><term>Respiration, Artificial</term><term>Rotation</term><term>Statistics, Nonparametric</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Courbe ROC</term><term>Décubitus ventral</term><term>Femelle</term><term>Humains</term><term>Hémodynamique</term><term>Mâle</term><term>Projets pilotes</term><term>Rotation</term><term>Statistique non paramétrique</term><term>Sujet âgé</term><term>Ventilation artificielle</term><term>Échanges gazeux pulmonaires</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To compare prone positioning and continuous rotational therapy with respect to oxygenation and hemodynamics in patients suffering from adult respiratory distress syndrome (ARDS).</p></div><div type="abstract" xml:lang="en"><p><b>DESIGN</b></p><p>Randomized, prospective pilot study.</p></div><div type="abstract" xml:lang="en"><p><b>SETTING</b></p><p>Intensive care unit at a university hospital.</p></div><div type="abstract" xml:lang="en"><p><b>PATIENTS</b></p><p>Twenty-six mechanically ventilated patients with ARDS from nontraumatic causes.</p></div><div type="abstract" xml:lang="en"><p><b>INTERVENTIONS</b></p><p>Twelve patients were turned prone (group 1), 14 patients underwent continuous axial rotation from one lateral position to the other with a maximum angle of 124 degrees in specially designed beds (group 2). All patients had received inhaled nitric oxide (NO) therapy before positioning.</p></div><div type="abstract" xml:lang="en"><p><b>MEASUREMENTS AND MAIN RESULTS</b></p><p>Gas exchange and hemodynamics were assessed using a pulmonary artery catheter. In both groups, an improvement in PaO2/RFIO2-ratio and intrapulmonary shunt fraction occurred after initiation of NO as well as during the first 72 hrs of positioning therapy. During the study period, seven patients died in group 1 and nine patients in group 2 (p = NS). Comparing the areas under the curve during the first 72 hrs, no significant differences with respect to PaO2/FIO2-ratio, PaCO2, positive end-expiratory and peak inspiratory pressure levels, intrapulmonary shunt fraction, the alveolar-arterial oxygen difference, and oxygen delivery and consumption, as well as cardiac index, pulmonary and arterial blood pressures, and pulmonary arterial occlusion pressure could be detected between the groups. Prone positioning was tolerated well, continuous rotational therapy had to be modified according to hemodynamic instability in three patients.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>In severe lung injury, continuous rotational therapy seems to exert effects comparable to prone positioning and could serve as alternative when prone positioning seems inadvisable.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">11176160</PMID><DateCompleted><Year>2001</Year><Month>02</Month><Day>08</Day></DateCompleted><DateRevised><Year>2019</Year><Month>07</Month><Day>06</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0090-3493</ISSN><JournalIssue CitedMedium="Print"><Volume>29</Volume><Issue>1</Issue><PubDate><Year>2001</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Critical care medicine</Title></Journal><ArticleTitle>Comparison of prone positioning and continuous rotation of patients with adult respiratory distress syndrome: results of a pilot study.</ArticleTitle><Pagination><MedlinePgn>51-6</MedlinePgn></Pagination><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To compare prone positioning and continuous rotational therapy with respect to oxygenation and hemodynamics in patients suffering from adult respiratory distress syndrome (ARDS).</AbstractText><AbstractText Label="DESIGN" NlmCategory="METHODS">Randomized, prospective pilot study.</AbstractText><AbstractText Label="SETTING" NlmCategory="METHODS">Intensive care unit at a university hospital.</AbstractText><AbstractText Label="PATIENTS" NlmCategory="METHODS">Twenty-six mechanically ventilated patients with ARDS from nontraumatic causes.</AbstractText><AbstractText Label="INTERVENTIONS" NlmCategory="METHODS">Twelve patients were turned prone (group 1), 14 patients underwent continuous axial rotation from one lateral position to the other with a maximum angle of 124 degrees in specially designed beds (group 2). All patients had received inhaled nitric oxide (NO) therapy before positioning.</AbstractText><AbstractText Label="MEASUREMENTS AND MAIN RESULTS" NlmCategory="RESULTS">Gas exchange and hemodynamics were assessed using a pulmonary artery catheter. In both groups, an improvement in PaO2/RFIO2-ratio and intrapulmonary shunt fraction occurred after initiation of NO as well as during the first 72 hrs of positioning therapy. During the study period, seven patients died in group 1 and nine patients in group 2 (p = NS). Comparing the areas under the curve during the first 72 hrs, no significant differences with respect to PaO2/FIO2-ratio, PaCO2, positive end-expiratory and peak inspiratory pressure levels, intrapulmonary shunt fraction, the alveolar-arterial oxygen difference, and oxygen delivery and consumption, as well as cardiac index, pulmonary and arterial blood pressures, and pulmonary arterial occlusion pressure could be detected between the groups. Prone positioning was tolerated well, continuous rotational therapy had to be modified according to hemodynamic instability in three patients.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">In severe lung injury, continuous rotational therapy seems to exert effects comparable to prone positioning and could serve as alternative when prone positioning seems inadvisable.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Staudinger</LastName><ForeName>T</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine I, University of Vienna, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kofler</LastName><ForeName>J</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Müllner</LastName><ForeName>M</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Locker</LastName><ForeName>G J</ForeName><Initials>GJ</Initials></Author><Author ValidYN="Y"><LastName>Laczika</LastName><ForeName>K</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Knapp</LastName><ForeName>S</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Losert</LastName><ForeName>H</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>Frass</LastName><ForeName>M</ForeName><Initials>M</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Crit Care Med</MedlineTA><NlmUniqueID>0355501</NlmUniqueID><ISSNLinking>0090-3493</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>31C4KY9ESH</RegistryNumber><NameOfSubstance UI="D009569">Nitric Oxide</NameOfSubstance></Chemical></ChemicalList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006439" MajorTopicYN="N">Hemodynamics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009569" MajorTopicYN="N">Nitric Oxide</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010865" MajorTopicYN="N">Pilot Projects</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="D011659" MajorTopicYN="N">Pulmonary Gas Exchange</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012372" MajorTopicYN="N">ROC Curve</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012128" MajorTopicYN="N">Respiratory Distress Syndrome, Adult</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012399" MajorTopicYN="Y">Rotation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018709" MajorTopicYN="N">Statistics, Nonparametric</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2001</Year><Month>2</Month><Day>15</Day><Hour>11</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2001</Year><Month>3</Month><Day>3</Day><Hour>10</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2001</Year><Month>2</Month><Day>15</Day><Hour>11</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">11176160</ArticleId><ArticleId IdType="doi">10.1097/00003246-200101000-00014</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Autriche</li></country></list><tree><noCountry><name sortKey="Frass, M" sort="Frass, M" uniqKey="Frass M" first="M" last="Frass">M. Frass</name><name sortKey="Knapp, S" sort="Knapp, S" uniqKey="Knapp S" first="S" last="Knapp">S. Knapp</name><name sortKey="Kofler, J" sort="Kofler, J" uniqKey="Kofler J" first="J" last="Kofler">J. Kofler</name><name sortKey="Laczika, K" sort="Laczika, K" uniqKey="Laczika K" first="K" last="Laczika">K. Laczika</name><name sortKey="Locker, G J" sort="Locker, G J" uniqKey="Locker G" first="G J" last="Locker">G J Locker</name><name sortKey="Losert, H" sort="Losert, H" uniqKey="Losert H" first="H" last="Losert">H. Losert</name><name sortKey="Mullner, M" sort="Mullner, M" uniqKey="Mullner M" first="M" last="Müllner">M. Müllner</name></noCountry><country name="Autriche"><noRegion><name sortKey="Staudinger, T" sort="Staudinger, T" uniqKey="Staudinger T" first="T" last="Staudinger">T. Staudinger</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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