Respiratory failure & ventilation
Effects of prone positioning on lung mechanical power components in patients with acute respiratory distress syndrome: a physiologic study
Authors' conclusion
In patients with moderate to severe ARDS, PP reduced lung total elastic and elastic static power compared with SP regardless of EELV normalization because comparable transpulmonary pressures and EELV were achieved at lower airway pressures.
Study context
- Population
- Patients with moderate to severe acute respiratory distress syndrome (ARDS)
- Participants
- 55 patients
- Exposure
- Prone vs supine positioning
- Outcome
- Effect of PP on lung total elastic power non-normalized and normalized to end-expiratory lung volume (EELV)
Methodological detailsesophageal pressure-guided ventilation, crossover of positions
- Esophageal pressure-guided ventilation
- Crossover of positions
Main finding
As reported in the abstract
Lung total elastic power
| Group | Value | Normalized to end-expiratory lung volume (EELV), median [IQR] J/min/L |
|---|---|---|
| Prone positioning (PP) | median 6.7 (IQR 4.9–10.6) J/min | 3.2 [2.1-5.0] |
| Supine positioning (SP) | median 11.0 (IQR 6.6–14.8) J/min | 5.3 [3.3-7.5] |
Value
Prone positioning (PP)median 6.7 (IQR 4.9–10.6) J/min
Supine positioning (SP)median 11.0 (IQR 6.6–14.8) J/min
Normalized to end-expiratory lung volume (EELV), median [IQR] J/min/L
Prone positioning (PP)3.2 [2.1-5.0]
Supine positioning (SP)5.3 [3.3-7.5]
- PP vs SP: P < 0.001 — non-normalized
- PP vs SP: P < 0.001 — normalized to EELV
Observational data: associations, not effects.
Secondary outcomes
Transpulmonary pressures, EELV, airway pressures and lung elastic static power
- Transpulmonary pressures and EELV not significantly different in PP vs SP despite lower PEEP and plateau airway pressure, reducing non-normalized and normalized lung elastic static power in PP
Gas exchange, cardiac output, oxygen delivery
- PP improved gas exchange, CO and increased oxygen delivery vs SP
Original publication
Effects of prone positioning on lung mechanical power components in patients with acute respiratory distress syndrome: a physiologic study. Crit Care. Published 15 March 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →