A Complex Hemodynamic Response After Prone Positioning in Acute Respiratory Distress Syndrome

The authors reply

“…Second, Jha and Jha (1) point out a discrepancy between our study (2), which shows that cardiac index (CI) increased during PP, and some previous studies reporting that venous return decreased when intra-abdominal pressure (IAP) rose greater than or equal to 10 mm Hg during laparoscopy. However, not all the laparoscopic studies found a decrease in CI with intra-abdominal hypertension (4, 5).…”

“…Third, Jha and Jha (1) point out the lack of “physiologic justification” of our finding. We respectfully disagree with this opinion, as we comprehensively investigated the factors that may affect CI during PP, including the determinants of venous return.…”

“…We thank Jha and Jha (1) for their interest in our article (2) published recently in Critical Care Medicine , and we want to respond point by point to their comments. First, they note that we did not use bolsters in our patients during prone positioning (PP).…”