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2016, Number 4

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Med Crit 2016; 30 (4)

Prone positioning in severe acute respiratory distress syndrome

Romano APV, Olvera GC, Rodríguez ZC, Gálvez BGA, Aguirre SJ, Franco GJ

Language: Spanish
References: 19
Page: 235-241
PDF size: 160.94 Kb.


ABSTRACT

Introduction: From the first definition of acute respiratory distress syndrome (ARDS), the treatment of this condition has been based on the correction of hypoxemia. Among the most studied alternative therapies is prone ventilation.
Objective: To demonstrate that prolonged prone ventilation applied early in patients with severe ARDS improves the oxygenation parameters.
Material and methods: Retrospective study conducted in the Department of Critical Medicine of the ABC Medical Center from March 2013 to July 2015.
Results: Thirty-four patients with severe ARDS were studied. Their response to the placement in the prone position was assessed according to their response in PaO2/FiO2. The permanence of the PaO2/FiO2 in supine position was greater in the group of pulmonary origin, 227 mmHg, compared to the extrapulmonary, 186 mmHg. The mortality of the population at 48 hours was 11.7% (four) and at 28 days 47% (16).
Discussion: In our study, 34 patients with a diagnosis of severe ARDS were included. All of those who were brought into a prone position and then returned to a supine position showed improvement upon the change from supine. Unfortunately, pronation effect on survival is still uncertain as improvement in oxygenation will not necessarily imply a reduction in mortality.
Conclusions: The prone ventilation continues to be a reliable measure in patients with severe ARDS, with improved levels of PaO2/FiO2, but no improvement in the mortality at 28 days.


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