Effect of prone position ventilation on hemodynamics and prognosis in patients with acute respiratory distress syndrome complicated with interstitial lung disease

Abstract

Objective To investigate the effect of prone position ventilation on hemodynamics and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with interstitial lung disease (ILD). Methods A total of 106 patients with ARDS were divided into ILD group and no ILD group according to the combination of ILD, with 53 cases in each group. Patients in the two groups were treated by prone ventilation on the basis of routine treatment until oxygenation index was greater than 200 mmHg (1 mmHg=0.133 kPa) or too worse to tolerate, and were followed up for 3 months. Hemodynamic indexes, respiratory indexes, blood gas analysis indexes and fatality rate were compared between the two groups before and after ventilation. Results Before ventilation, hemodynamics, respiratory mechanics index, the index of blood gas analysis of two groups were compared, the differences were not significant (P>0.05). After ventilation, tidal volume ventilation (VT) was compared with that before ventilation, the difference was not significant (P>0.05), the other indexes were improved than those before, and the differences were significant (P<0.05). After a three-month follow-up, the case fatality rate in group ILD was 15.09% (8/53), which was higher than that in no ILD group 3.77% (2/53), the difference was significant (P<0.05). Conclusions ILD prone position ventilation in the treatment of ARDS patients can improve the arterial blood gas analysis and respiratory function, but cannot affect hemodynamics significantly. Key words: Acute respiratory distress syndrome; Interstitial lung disease; Prone position ventilation; Blood rheology