Respiratory failure & ventilation
Early reapplication of prone position during venovenous ECMO for acute respiratory distress syndrome: a prospective observational study and propensity-matched analysis
Authors' conclusion
Patients with severe ARDS placed in PP before VV-ECMO should continue PP after VV-ECMO support. This approach could increase the probability of successful weaning from VV-ECMO.
Study context
- Population
- Patients with severe acute respiratory distress syndrome (ARDS) treated with VV-ECMO who received prone positioning (PP) before ECMO45 matched per group
- Participants
- 165 patients
- Exposure
- Early prone position during VV-ECMO vs supine
- Pronen = 50
- Supinen = 115reference
- Outcome
- Proportion of patients successfully weaned from VV-ECMO
Methodological detailspropensity-score matched
- Propensity-score matched
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Successful weaning from VV-ECMO (propensity-matched sample)
P = 0.035
60-day mortality (propensity-matched sample)
P = 0.035
- Successful weaning from VV-ECMO (propensity-matched sample): propensity score-matched, 45 per group
- 60-day mortality (propensity-matched sample): propensity score-matched, 45 per group
Physiological effects during PP
- Significant increase in pressure of arterial oxygen (PaO2) without change in ventilator or ECMO settings
- Tidal impedance shifted significantly to the dorsal region
- Lung ultrasound scores significantly decreased in anterior and posterior regions
Original publication
Early reapplication of prone position during venovenous ECMO for acute respiratory distress syndrome: a prospective observational study and propensity-matched analysis. Ann Intensive Care. Published 20 August 2024. doi:10.
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