Research of reformative prone position ventilation in patients with acute respiratory distress syndrome

Abstract

Objective To investigate the effect of reformative ventilation method (head-high leg-low 30°-declivate prone position ) in the ventilation of acute respiratory distress syndrome ( ARDS ) patients, and compared with normal prone position ventilation. Methods Forty-four patients of ARDS underwent ventilation were divided into prone position group (22 cases) and reformative prone position group (22cases) by random digits talle. Continuous 30° semireclining position was kept in normal time. The patients of the two groups underwent different prone position ventilation 4 hours every day,and indexes of hemodynamics and respiration before,during and after prone position ventilation were recorded and analyzed. Results After prone position ventilation, oxygenation index of two groups improved similarly (P ＞ 0.05 ). In prone position group, lung compliance decreased [2 h, ( 25.6 ± 5.8 ) ml/cm H2O ( 1 cm H2O = 0.098 kPa) vs. ( 37.2 ± 20.5 )ml/cm H2O] ,average airway pressure increased [2 h, ( 18.5 ± 3.9) cm H2O vs. ( 15.6 ± 5.3 )cm H2O] ,heart rate increased [2 h, ( 112.0 ± 16.2 ) beats/min vs. ( 102.0 ± 11.3 ) beats/min], mean arterial blood pressure decreased [2 h, (86.0 ± 6.7) mm Hg ( 1 mm Hg = 0.133 kPa) vs. (93.5 ± 7.5 ) mm Hg] ,central venous pressure increased[2 h, ( 15.5 ± 3.3 ) cm H2O vs. ( 12.6 ± 4.3 ) cm H2O]. These changes persistently existed during prone position ventilation (P ＜ 0.05 ),and they disappeared in 1 hour when recovered to 30 °semireclining position. Conclusion Reformative prone position ventilation not only has same effect on improving oxygenation index, but also obviates adverse effect on lung compliance and hemodynamics. Key words: Respiratory distress syndrome,adult; Ventilators, mechanical; Prone position; Reformative prone position