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01.06.2009 | Original

Relationship between gas exchange response to prone position and lung recruitability during acute respiratory failure

verfasst von: Alessandro Protti, Davide Chiumello, Massimo Cressoni, Eleonora Carlesso, Cristina Mietto, Virna Berto, Marco Lazzerini, Michael Quintel, Luciano Gattinoni

Erschienen in: Intensive Care Medicine | Ausgabe 6/2009

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Abstract

Purpose

To clarify whether the gas exchange response to prone position is associated with lung recruitability in mechanically ventilated patients with acute respiratory failure.

Methods

In 32 patients, gas exchange response to prone position was investigated as a function of lung recruitability, measured by computed tomography in supine position.

Results

No relationship was found between increased oxygenation in prone position and lung recruitability. In contrast, the decrease of PaCO₂ was related with lung recruitability (R ² 0.19; P = 0.01). Patients who decreased their PaCO₂ more than the median value (−0.9 mmHg) had a greater lung recruitability (19 ± 16 vs. 8 ± 6%; P = 0.02), higher baseline PaCO₂ (48 ± 8 vs. 41 ± 11 mmHg; P = 0.07), heavier lungs (1,968 ± 829 vs. 1,521 ± 342 g; P = 0.06) and more non-aerated tissue (1,009 ± 704 vs. 536 ± 188 g; P = 0.02) than those who did not.

Conclusions

During prone position, changes in PaCO₂, but not in oxygenation, are associated with lung recruitability which, in turn, is associated with the severity of lung injury.

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Titel: Relationship between gas exchange response to prone position and lung recruitability during acute respiratory failure
verfasst von: Alessandro Protti
Davide Chiumello
Massimo Cressoni
Eleonora Carlesso
Cristina Mietto
Virna Berto
Marco Lazzerini
Michael Quintel
Luciano Gattinoni
Publikationsdatum: 01.06.2009
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 6/2009
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1411-x

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