Positive end-expiratory pressure affects regional redistribution of ventilation differently in prone and supine sheep*

Johansson, Maria; Wiklund, Andreas; Flatebø, Torun; Nicolaysen, Anne; Nicolaysen, Gunnar; Walther, Sten

doi:10.1097/01.ccm.0000142395.82277.6f

Cited by 32 publications

(16 citation statements)

References 29 publications

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“…This tendency toward a more heterogeneous ventilation pattern in the supine position was also demonstrated in an animal model ventilated with a PEEP of 10 cm H 2 O, while ventilating in prone position eliminated the dorsal-to-ventral gradient. 39 All these results are consistent with our findings, as we noted a higher EELI increase in the non-dependent lung regions in the supine position than in the dependent regions. This homogeneity of air distribution may be of interest in hypoxemic patients, in whom prone positioning could improve the oxygenation efficacy of the high-flow oxygen therapy, since it has been suggested that response in P aO 2 is associated with a more homogeneous regional inflation.…”

Section: Discussionsupporting

confidence: 82%

Effect of High-Flow Nasal Cannula and Body Position on End-Expiratory Lung Volume: A Cohort Study Using Electrical Impedance Tomography

et al. 2013

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BACKGROUND: Electrical impedance tomography measures changes in lung impedance, which are mainly related to changes in lung volume. We used electrical impedance tomography to investigate the effects of high-flow nasal cannula (HFNC) and body position on global and regional end-expiratory lung impedance variation (⌬EELI). METHODS: Prospective study with 20 healthy adults. Two periods were defined: the first in supine position and the second in prone position. Each period was divided into 3 phases. In the first and the third phases the subjects were breathing ambient air, and in the second HFNC was implemented. Four regions of interest were defined: 2 ventral and 2 dorsal. All men by nature desire to know.-Aristotle, Metaphysics

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Section: Discussionsupporting

confidence: 82%

Effect of High-Flow Nasal Cannula and Body Position on End-Expiratory Lung Volume: A Cohort Study Using Electrical Impedance Tomography

et al. 2013

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“…The unique findings in the present study shows that the ventilation becomes more uniform with PEEP in prone with redistribution from dependent to non-dependent lung region and gravitational component of ventilation. 23 The beneficial outcome with increase PO2/FIO2 response to prone position might be because of decrease in PCO2. 24 In the present study 2 pregnant patients with ARDS were given abdomen free prone position with improvement in SaO2 after 1 hour.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of supine lying, side lying and prone positioning on oxygen saturation, in mechanically ventilated patients, in acute respiratory failure

Patil

Nagarwala

2015

Int J Res Med Sci

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“…The lungs provide and ideal example of a paired organ system where variations in anatomy, position, and perfusion have profound effects on mate pulmonary function and underlying pathology. 10 It seems logical that such factors could be at play in kidney physiology.…”

Section: Discussionmentioning

confidence: 99%

Differences in quantitative urine composition in stone-forming versus unaffected mate kidneys

Konety¹

2009

RRU

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Objectives: Many patients present with bilateral stones. There is a unique group of patients, however, that presents with stones exclusively on one side. We hypothesize that in such situations, 24-hour urine collections may not reveal specific defects on the affected stone-bearing kidney. We therefore evaluated selective 12-hour urine collections after percutaneous nephrolithotomy (PNL) to help determine if there is differential renal excretion. Methods: We collected urine specimens from patients with nephrolithiasis who underwent unilateral PNL. Urine samples were collected and analyzed from nephrostomy tubes, representing the affected kidneys, and from Foley bladder catheters, representing the contralateral mate kidney. Results: Thirty-one patients were studied (14 with unilateral nephrolithiasis and 17 with bilateral). Treated kidneys from patients with unilateral nephrolithiasis displayed lowered urine excretion of uric acid, sodium, chloride, calcium, and total osmoles when compared to patients with bilateral nephrolithiasis. Stone size and length of procedure were not predictive of urine composition after PNL. Conclusions: Treated kidneys from patients with a history of unilateral stone disease revealed marked differences in urine excretion compared to those with bilateral nephrolithiasis after unilateral PNL. These findings could be secondary to the surgical insult, urinary stone disease, or could be a responsible factor for stone pathogenesis.

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Positive end-expiratory pressure affects regional redistribution of ventilation differently in prone and supine sheep*

Abstract: The wet fluorescent microsphere aerosol was as reliable as Technegas for high-resolution measurements of regional ventilation. The markedly different effects of 10 PEEP in supine and prone sheep may have important implications for gas exchange both in noninjured and injured lungs.

Cited by 32 publications

References 29 publications

Effect of High-Flow Nasal Cannula and Body Position on End-Expiratory Lung Volume: A Cohort Study Using Electrical Impedance Tomography

Effect of High-Flow Nasal Cannula and Body Position on End-Expiratory Lung Volume: A Cohort Study Using Electrical Impedance Tomography

A comparative study of supine lying, side lying and prone positioning on oxygen saturation, in mechanically ventilated patients, in acute respiratory failure

Differences in quantitative urine composition in stone-forming versus unaffected mate kidneys

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