Influence of support on intra-abdominal pressure, hepatic kinetics of indocyanine green and extravascular lung water during prone positioning in patients ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2005-03-31

AUTHORS

Pierre Michelet, Antoine Roch, Marc Gainnier, Jean-Marie Sainty, Jean-Pierre Auffray, Laurent Papazian

ABSTRACT

INTRODUCTION: Prone positioning (PP) on an air-cushioned mattress is associated with a limited increase in intra-abdominal pressure (IAP) and an absence of organ dysfunction. The respective influence of posture by itself and the type of mattress on these limited modifications during the PP procedure remains unclear. The aim of this study was to evaluate whether the type of support modifies IAP, extravascular lung water (EVLW) and the plasma disappearance rate of indocyanine green (PDRICG) during PP. METHODS: A prospective, randomized, crossover study of 20 patients with acute respiratory distress syndrome (ARDS) was conducted in a medical intensive care unit in a teaching hospital. Measurements were made at baseline and repeated after 1 and 6 hours of two randomized periods of 6 hours of PP with one of two support types: conventional foam mattress or air-cushioned mattress. RESULTS: After logarithmic transformation of the data, an analysis of variance (ANOVA) showed that IAP and PDRICG were significantly influenced by the type of support during PP with an increase in IAP (P < 0.05 by ANOVA) and a decrease in PDRICG on the foam mattress (P < 0.05 by ANOVA). Conversely, the measurements of EVLW did not show significant modification between the two supports whatever the posture. The ratio of the arterial oxygen tension to the fraction of inspired oxygen significantly increased in PP (P < 0.0001 by ANOVA) without any influence of the support. CONCLUSION: In comparison with a conventional foam mattress, the use of an air-cushioned mattress limited the increase in IAP and prevented the decrease in PDRICG related to PP in patients with ARDS. Conversely, the type of support did not influence EVLW or oxygenation. More... »

PAGES

r251-r257

References to SciGraph publications

  • 1996-10. Improved oxygenation utilizing a prone positioner in patients with acute respiratory distress syndrome in INTENSIVE CARE MEDICINE
  • 2001-12-04. Prone positioning, systemic hemodynamics, hepatic indocyanine green kinetics, and gastric intramucosal energy balance in patients with acute lung injury in INTENSIVE CARE MEDICINE
  • 1987-01-01. Volume/pressure curve of total respiratory system in paralysed patients: artefacts and correction factors in INTENSIVE CARE MEDICINE
  • 1999-12-01. Abdominal pressure in the critically ill: measurement and clinical relevance in INTENSIVE CARE MEDICINE
  • 2004-02-03. Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study in INTENSIVE CARE MEDICINE
  • 2002-10-26. Effect of prone position on hepato-splanchnic hemodynamics in acute lung injury in INTENSIVE CARE MEDICINE
  • 2001-03. Abdomen release in prone position does not improve oxygenation in an experimental model of acute lung injury in INTENSIVE CARE MEDICINE
  • 2002-03-20. What is the optimal duration of ventilation in the prone position in acute lung injury and acute respiratory distress syndrome? in INTENSIVE CARE MEDICINE
  • 2001-07. Influence of prone position on gastric mucosal-arterial PCO2 gradients in INTENSIVE CARE MEDICINE
  • 1995. Transpulmonary Indicator Dilution: An Alternative Approach for Hemodynamic Monitoring in YEARBOOK OF INTENSIVE CARE AND EMERGENCY MEDICINE
  • 2000-04. Effect of positive end-expiratory pressure on splanchnic perfusion in acute lung injury in INTENSIVE CARE MEDICINE
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/cc3513

    DOI

    http://dx.doi.org/10.1186/cc3513

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1048373897

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/15987398


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