Respiratory failure & ventilation
Effects of early versus delayed application of prone position on ventilation–perfusion mismatch in patients with acute respiratory distress syndrome: a prospective observational study
Authors' conclusion
Prone position significantly reduced V/Q mismatch in patients with early ARDS, while it increased V/Q mismatch in persistent ARDS patients.
Study context
- Population
- Adults with moderate-to-severe acute respiratory distress syndrome (ARDS) ventilated in supine and prone position, medical ICU, Zhongda Hospital, Southeast University
- Participants
- 57 adults
- Exposure
- Prone vs supine position in early vs persistent ARDS
- Early ARDSn = 33
- Persistent ARDSn = 24
- Outcome
- Regional ventilation and perfusion (V/Q) distribution by electrical impedance tomography, supine vs prone
- Follow-up
- 12 h after a prone session
Methodological detailssingle-centre, consecutive patients, electrical impedance tomography, June 30, 2021, to October 1, 2022
- Single-centre
- Consecutive patients
- Electrical impedance tomography
- June 30, 2021, to October 1, 2022
Main finding
As reported in the abstract
V/Q mismatch, supine vs prone
- Early ARDS: prone vs Early ARDS: supine: P < 0.001
- Persistent ARDS: prone vs Persistent ARDS: supine: P = 0.006
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Oxygenation, supine vs proneEarly ARDS: prone vs Early ARDS: supine | P < 0.001 |
| Oxygenation, supine vs pronePersistent ARDS: prone vs Persistent ARDS: supine | P = 0.10 |
- Oxygenation, supine vs prone: 157 [121, 191] vs 190 [164, 245] mm Hg; significantly improved
- Oxygenation, supine vs prone: 168 [136, 232] vs 177 [155, 232] mm Hg; no significant change
Regional shunt and dead space
- Early ARDS: proning significantly reduced dorsal shunt and ventral dead space
- Persistent ARDS: proning increased global shunt
Correlation of ARDS onset-to-proning duration with change in V/Q distribution
- R
- 0.54
- P
- P < 0.001
Original publication
Effects of early versus delayed application of prone position on ventilation–perfusion mismatch in patients with acute respiratory distress syndrome: a prospective observational study. Crit Care. Published 27 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →