Abdomen release in prone position does not improve oxygenation in an experimental model of acute lung injury

被引:12
作者
Colmenero-Ruiz, M [1 ]
de Guzmán, DPG [1 ]
Jiménez-Quintana, MD [1 ]
Fernández-Mondejar, E [1 ]
机构
[1] Virgen Nieves Hosp, Dept Intens Med, Granada 18014, Spain
关键词
acute lung injury; extravascular lung water; mechanical ventilation; oleic acid; pulmonary edema; prone position;
D O I
10.1007/s001340100858
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To analyze the effect of abdomen release in the prone position on oxygenation in an experimental model of acute lung injury. Design: Experimental randomized controlled study. Setting: Experimental laboratory of a tertiary university hospital. Participants: Mixed-breed adolescent pigs weighing between 25-31 kg. Interventions: Thirty minutes after pulmonary edema was produced with oleic acid, the animals were turned prone and randomized into two groups: group I or control (n = 9), lying directly on the operating table; and group II (n = 11) with abdomen release, with positioning roils under the upper part of the chest wall and the pelvis to allow free movement of the abdomen. Measurements and results: The gas exchange, respiratory mechanics, hemodynamics, intra-abdominal pressure (IAP) and the extravascular lung water (EVLW), determined by double indicator dilution method (DI), were recorded at baseline (time 0) and at 30, 60, 90, 120 and 150 min. The PaO2/FIO2 increased in both groups at 30 min after the pigs were placed in the prone position (time 60) and then decreased progressively until the end of the experimental period, with no statistical differences between the groups at any time (73.1 +/- 14.5 vs 79.5 +/- 14.9 at 150 min). Abdomen release was not associated with changes in the respiratory mechanics, EVLW or intra-abdominal pressure. Conclusions: Abdomen release in prone position does not improve oxygenation in an experimental model of acute lung injury.
引用
收藏
页码:566 / 573
页数:8
相关论文
共 29 条
  • [1] ALBERT RK, 1987, AM REV RESPIR DIS, V135, P628
  • [2] Prone position in ARDS: What do we know, and what do we need to know?
    Albert, RK
    [J]. CRITICAL CARE MEDICINE, 1999, 27 (11) : 2574 - 2575
  • [3] GAS-EXCHANGE IN DOGS IN THE PRONE AND SUPINE POSITIONS
    BECK, KC
    VETTERMANN, J
    REHDER, K
    [J]. JOURNAL OF APPLIED PHYSIOLOGY, 1992, 72 (06) : 2292 - 2297
  • [4] THE AMERICAN-EUROPEAN CONSENSUS CONFERENCE ON ARDS - DEFINITIONS, MECHANISMS, RELEVANT OUTCOMES, AND CLINICAL-TRIAL COORDINATION
    BERNARD, GR
    ARTIGAS, A
    BRIGHAM, KL
    CARLET, J
    FALKE, K
    HUDSON, L
    LAMY, M
    LEGALL, JR
    MORRIS, A
    SPRAGG, R
    COCHIN, B
    LANKEN, PN
    LEEPER, KV
    MARINI, J
    MURRAY, JF
    OPPENHEIMER, L
    PESENTI, A
    REID, L
    RINALDO, J
    VILLAR, J
    VANASBECK, BS
    DHAINAUT, JF
    MANCEBO, J
    MATTHAY, M
    MEYRICK, B
    PAYEN, D
    PERRET, C
    FOWLER, AA
    SCHALLER, MD
    HUDSON, LD
    HYERS, T
    KNAUS, W
    MATTHAY, R
    PINSKY, M
    BONE, RC
    BOSKEN, C
    JOHANSON, WG
    LEWANDOWSKI, K
    REPINE, J
    RODRIGUEZROISIN, R
    ROUSSOS, C
    ANTONELLI, MA
    BELOUCIF, S
    BIHARI, D
    BURCHARDI, H
    LEMAIRE, F
    MONTRAVERS, P
    PETTY, TL
    ROBOTHAM, J
    ZAPOL, W
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1994, 149 (03) : 818 - 824
  • [5] Influence of prone position on the extent and distribution of lung injury in a high tidal volume oleic acid model of acute respiratory distress syndrome
    Broccard, AF
    Shapiro, RS
    Schmitz, LL
    Ravenscraft, SA
    Marini, JJ
    [J]. CRITICAL CARE MEDICINE, 1997, 25 (01) : 16 - 27
  • [6] Prone position in mechanically ventilated patients with severe acute respiratory failure
    Chatte, G
    Sab, JM
    Dubois, JM
    Sirodot, M
    Gaussorgues, P
    Robert, D
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1997, 155 (02) : 473 - 478
  • [7] PEEP and low tidal volume ventilation reduce lung water in porcine pulmonary edema
    ColmeneroRuiz, M
    FernandezMondejar, E
    FernandezSacristan, MA
    RiveraFernandez, R
    VazquezMata, G
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1997, 155 (03) : 964 - 970
  • [8] Curley M A, 1999, Am J Crit Care, V8, P397
  • [9] DANTZKER D R, 1986, Critical Care Clinics, V2, P527
  • [10] DOUGLAS WW, 1977, AM REV RESPIR DIS, V115, P559