Respiratory failure & ventilation
Respiratory effects of prone position in COVID-19 acute respiratory distress syndrome differ according to the recruitment-to-inflation ratio: a prospective observational study
Authors' conclusion
A lower PaO2/FiO2 at baseline and a positive O2-response at the previous PP session are associated with a PP-induced improvement in oxygenation. In higher-recruiters, lung mechanics improved along with oxygenation.
Study context
- Population
- Patients undergoing prone position for COVID-19 acute respiratory distress syndrome (ARDS)201 prone position (PP) sessions
- Participants
- 50 patients
- Exposure
- Lower-recruiters vs Higher-recruiters
- Outcome
- Positive oxygenation response to PP (PaO2/FiO2 improvement ≥ 20 mmHg) and baseline variables associated with it, including R/I
- Follow-up
- End of PP session
Methodological detailssingle-centre, PP sessions lasted 19 ± 3 h, NMB used in 116 (58%) sessions
- Single-centre
- PP sessions lasted 19 ± 3 h
- NMB used in 116 (58%) sessions
Main finding
As reported in the abstract
Baseline variables associated with oxygenation improvement with PP (PaO2/FiO2 increase ≥ 20 mmHg)
Odds ratio (95% CI)P value
Pre-PP PaO2/FiO2, every decrease of 10 mmHgfirst model
1.12(1.01–1.24)
P = 0.034Improvement in oxygenation at the previous PP sessionsecond model
3.69(1.27–10.72)
P = 0.017Every decrease of 10 mmHg, as printed
- Sessions with PaO2/FiO2 increase ≥ 20 mmHg
- 142 (71%)
Observational data: associations, not effects.
Further findings
R/I ratio (n = 156 sessions)
- R/I ratio, separating lower- and higher-recruiters
- 0.53 (0.30-0.76)
PaO2/FiO2 by recruiter subgroup
- PaO2/FiO2 improved to the same level in both subgroups
Driving pressure in higher-recruiters (before vs end of PP)
- Driving pressure, before to end of PP (cmH2O)
- from 14 ± 4 to 12 ± 4
- p = 0.027
- Improved only in higher-recruiters
Respiratory system compliance in higher-recruiters (before vs end of PP)
- Compliance, before to end of PP (mL/cmH2O)
- from 34 ± 11 to 38 ± 13
- p = 0.014
- Improved only in higher-recruiters
Original publication
Respiratory effects of prone position in COVID-19 acute respiratory distress syndrome differ according to the recruitment-to-inflation ratio: a prospective observational study. Ann Intensive Care. Published 18 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →