Response to the prone position in spontaneously breathing patients with hypoxemic respiratory failure

Valter, C.; Christensen, Anders Mark; Tollund, Carsten; Schønemann, Niels Kim

doi:10.1034/j.1399-6576.2003.00088.x

Cited by 89 publications

(98 citation statements)

References 10 publications

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“…The observation by Valter et al (2003) is of interest. This is the only study, identified in this literature search, which used PP on awake and spontaneously breathing patients as treatment for hypoxaemic respiratory failure.…”

Section: Discussionmentioning

confidence: 98%

“…However, it has been noted during this literature review that nearly all studies on the effect of PP have only included participants with an already established ARDS. Only one study using PP in awake and spontaneously breathing patients as treatment for hypoxaemic respiratory failure in which mechanical ventilation was indicated (Valter et al, 2003) was identified. In a case study of four patients, Valter et al (2003) turned the patients to PP while being awake and breathing spontaneously.…”

Section: Prone Positioningmentioning

confidence: 99%

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Body positioning and its effect on oxygenation – a literature review

Marklew¹

2006

Nursing in Critical Care

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Evidence-based health care has become a priority in the National Health Service (NHS), with increased emphasis on clinical practices that are grounded in quality evidence rather than those that persist because of tradition. Turning and positioning of patients are well-accepted nursing activities. Appropriate positioning of the critically ill patient can dramatically improve gas exchange, resulting in a shorter stay in the critical care unit and an improved outcome. This study reviews the current published literature on the subject of positioning and gas exchange, with emphasis on oxygenation. Conclusions made from this study are that nurses need to be aware of how different positions can affect patients' oxygenation. Further research on exploring patients' experience of positioning within the critical care environment and nurses' understanding of positioning and oxygenation is needed.

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Section: Discussionmentioning

confidence: 98%

Section: Prone Positioningmentioning

confidence: 99%

Body positioning and its effect on oxygenation – a literature review

Marklew¹

2006

Nursing in Critical Care

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“…Accordingly, in the presented study, the slope of the V R gradient is less steep at the second measurement in both positions due to increased hypoventilation compared with the first measurement, which is supported by the trend of more pronounced differences between the two measurements in the gravitationally dependent lung regions preferably in the supine position measurement. The more stable gradient of the prone position is associated with an improved ventilation (oxygenation) in the prone position, which is in concordance with the fact that the prone position is commonly used in intensive care unit in patients with respiratory failure …”

Section: Discussionmentioning

confidence: 99%

“…Hypoventilated regions seemed to be reduced in the prone position ( Figure 7). As discussed in previous publications, 44,45 one would assume that the amount of tissue subjected to hypoventilation/atelectasis is the same in the supine and prone positions. However, Tobin and Kelly 46 reported that there are different amounts of compression of the dependent lung regions by the mediastinum and heart in the prone versus the supine position, which leads to less pronounced hypoventilation in dependent parts of lungs in the prone position.…”

Section: Anterior-posterior Gradient Of Ventilationmentioning

confidence: 99%

Free‐breathing quantification of regional ventilation derived by phase‐resolved functional lung (PREFUL) MRI

et al. 2019

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Purpose To test the feasibility of regional fully quantitative ventilation measurement in free breathing derived by phase‐resolved functional lung (PREFUL) MRI in the supine and prone positions. In addition, the influence of T2* relaxation time on ventilation quantification is assessed. Methods Twelve healthy volunteers underwent functional MRI at 1.5 T using a 2D triple‐echo spoiled gradient echo sequence allowing for quantitative measurement of T2* relaxation time. Minute ventilation (ΔV) was quantified by conventional fractional ventilation (FV) and the newly introduced regional ventilation (VR), which corrects volume errors due to image registration. ΔVFV versus ΔVVR and ΔVVR versus ΔVVR with T2* correction were compared using Bland–Altman plots and correlation analysis. The repeatability and physiological plausibility of all measurements were tested in the supine and prone positions. Results On global and regional scales a strong correlation was observed between ΔVFV versus ΔVVR and ΔVVR versus ΔVVRT2* (r > 0.93); however, regional Bland–Altman analysis showed systematic differences (p < 0.0001). Unlike ΔVVRT2*, ΔVVR and ΔVFV showed expected physiologic anterior–posterior gradients, which decreased in the supine but not in the prone position at second measurement during 3 min in the same position. For all quantification methods a moderate repeatability (coefficient of variation <20%) of ventilation was found. Conclusion A fully quantified regional ventilation measurement using ΔVVR in free breathing is feasible and shows physiologically plausible results. In contrast to conventional ΔVFV, volume errors due to image registration are eliminated with the ΔVVR approach. However, correction for the T2* effect remains challenging.

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“…Reports of the application of PP in spontaneously breathing, non-intubated adult patients are limited to few case reports [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Prone positioning improves oxygenation in spontaneously breathing nonintubated patients with hypoxemic acute respiratory failure: A retrospective study

Scaravilli

Grasselli

Castagna

et al. 2015

Journal of Critical Care

249

232

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Response to the prone position in spontaneously breathing patients with hypoxemic respiratory failure

Abstract: The prone position may prove beneficial in some cases of hypoxemic respiratory failure, even in awake patients, by avoiding mechanical ventilation and ventilator-associated complications.

Cited by 89 publications

References 10 publications

Body positioning and its effect on oxygenation – a literature review

Body positioning and its effect on oxygenation – a literature review

Free‐breathing quantification of regional ventilation derived by phase‐resolved functional lung (PREFUL) MRI

Prone positioning improves oxygenation in spontaneously breathing nonintubated patients with hypoxemic acute respiratory failure: A retrospective study

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