Background
Methods
Patients
Protocol
Measurements
Calculation of lung volumes and strain
Statistical analysis
Results
Patient | Age (years) | Days on MV before study | SAPS III | Vt (ml/kg PBW) | RR (rpm) | PEEP (cm H2O) | Pplat (cm H2O) | Δ Paw (cm H2O) | PaO2/FiO2 (mm Hg) | PaCO2 (mm Hg) | Cause of ARDS | Outcome |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 43 | 6 | 65 | 7.4 | 24 | 8 | 28 | 20 | 255 | 40 | Pneumonia | S |
2 | 66 | 1 | 52 | 6.1 | 22 | 10 | 20 | 10 | 254 | 60 | Pneumonia | S |
3 | 77 | 5 | 91 | 6.7 | 20 | 10 | 22 | 12 | 165 | 44 | Pneumonia | S |
4 | 68 | 4 | 69 | 8.4 | 24 | 12 | 21 | 9 | 255 | 44 | Pneumonia | S |
5 | 75 | 4 | 65 | 7.8 | 22 | 10 | 18 | 8 | 115 | 38 | Pneumonia | S |
6 | 65 | 7 | 94 | 9.2 | 30 | 10 | 21 | 11 | 240 | 53 | Pneumonia | S |
7 | 55 | 2 | 67 | 6.8 | 20 | 10 | 22 | 12 | 229 | 35 | Peritonitis | S |
8 | 43 | 2 | 77 | 8.1 | 20 | 8 | 26 | 18 | 151 | 48 | Peritonitis | D |
9 | 78 | 3 | 100 | 6.3 | 27 | 10 | 29 | 19 | 188 | 41 | Peritonitis | D |
10 | 74 | 2 | 82 | 11.0 | 25 | 10 | 28 | 18 | 198 | 43 | Pneumonia | D |
11 | 81 | 4 | 89 | 6.7 | 24 | 10 | 20 | 10 | 230 | 34 | Septic shock | S |
12 | 30 | 4 | 83 | 6.8 | 21 | 10 | 23 | 13 | 265 | 41 | Septic shock | D |
13 | 58 | 5 | 71 | 5.0 | 30 | 10 | 20 | 10 | 173 | 43 | Pneumonia | S |
14 | 69 | 1 | 101 | 5.9 | 28 | 10 | 28 | 18 | 300 | 44 | Septic shock | D |
15 | 50 | 14 | 95 | 6.0 | 30 | 10 | 25 | 15 | 206 | 42 | Septic shock | D |
16 | 55 | 3 | 68 | 7.0 | 20 | 8 | 19 | 11 | 129 | 37 | Thoracic Trauma | S |
17 | 30 | 4 | 64 | 6.2 | 24 | 12 | 22 | 10 | 104 | 41 | Pneumonia | S |
18 | 37 | 3 | 76 | 5.0 | 30 | 12 | 22 | 10 | 299 | 29 | Pneumonia | D |
19 | 80 | 2 | 82 | 6.1 | 17 | 12 | 19 | 7 | 230 | 35 | Pneumonia | S |
20 | 31 | 5 | 65 | 6.7 | 26 | 12 | 27 | 15 | 218 | 24 | Pancreatitis | D |
Mean ± SD | 58 ± 18 | 4 ± 3 | 78 ± 14 | 6.9 ± 1.4 | 24 ± 4 | 10 ± 1 | 23 ± 4 | 13 ± 4 | 41 ± 8 | 41 ± 8 |
Variable | Supine n = 20 | Prone n = 20 |
p
|
---|---|---|---|
PaO2/FiO2 (mm Hg) | 210 ± 57 | 281 ± 109 | 0.021 |
PaCO2 (mm Hg) | 41 ± 8 | 42 ± 9 | 0.400 |
Peak airway pressure (cm H2O) | 41 ± 7 | 41 ± 6 | 0.284 |
Pplat (cm H2O) | 23 ± 4 | 23 ± 4 | 0.446 |
Compliance (ml/cm H2O) | 36 ± 11 | 37 ± 10 | 0.594 |
Δ Paw (cm H2O) | 13 ± 4 | 12 ± 4 | 0.446 |
FRC (ml) | 965 ± 397 | 1140 ± 490 | 0.021 |
EELV (ml) | 1566 ± 476 | 1832 ± 719 | 0.009 |
Vt delivered from ZEEP, that generated a Pplat equal to basal PEEP [ml (n = 16)] | 333 ± 105 | 360 ± 127 | 0.073 |
Vrec [ml (n = 16)] | 269 ± 186 | 324 ± 188 | 0.501 |
Dynamic strain at ZEEP | 0.52 ± 0.23 | 0.44 ± 0.18 | 0.040 |
Dynamic strain at PEEP (n = 16) | 0.38 ± 0.14 | 0.33 ± 0.13 | 0.020 |
Static strain at PEEP (n = 16) | 0.51 ± 0.16 | 0.48 ± 0.13 | 0.438 |
Global strain at PEEP (n = 16) | 0.89 ± 0.24 | 0.81 ± 0.18 | 0.121 |