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Effects of prone position on inflammatory markers in patients with ARDS due to community-acquired pneumonia.
- Source :
-
Journal of the Formosan Medical Association = Taiwan yi zhi [J Formos Med Assoc] 2007 Sep; Vol. 106 (9), pp. 708-16. - Publication Year :
- 2007
-
Abstract
- Background/purpose: Acute respiratory distress syndrome (ARDS) is a serious disorder of intensive care unit patients. We evaluated the safety of continuous prone position ventilation (PRONE) and its effects on oxygenation and plasma cytokine concentrations in patients with ARDS caused by severe community-acquired pneumonia (CAP).<br />Methods: This was a prospective observational clinical study conducted in a respiratory intensive care unit of a 1200-bed medical center in central Taiwan. Twenty-two patients with severe CAP and ARDS were included. They were treated by traditional supine ventilation (SUPINE, n = 11) or PRONE (n = 11) if they met the criteria for ARDS. Patients in the PRONE group were ventilated in prone position continuously for at least 72 hours. Plasma cytokines were collected and analyzed at baseline, 24 hours and 72 hours after enrolment. Serial PaO2/FiO2 and complications were evaluated.<br />Results: Complications associated with PRONE were minor and self-limited. PRONE had higher PaO2/FiO2 ratio than SUPINE did at 48 hours after enrolment. The levels of plasma IL-6 concentration declined significantly with time in the PRONE group (p = 0.011). The levels of plasma IL-6 concentration at enrolment, 24 hours and 72 hours after enrolment also predicted the 14th day mortality of all patients.<br />Conclusion: PRONE was a safe and effective maneuver for improving oxygenation in patients with severe CAP and ARDS. PRONE also influenced IL-6 expression in patients with severe CAP.
- Subjects :
- Aged
Female
Humans
Male
Middle Aged
Oxygen blood
Positive-Pressure Respiration
Prospective Studies
Respiratory Distress Syndrome etiology
Respiratory Distress Syndrome therapy
Community-Acquired Infections complications
Cytokines blood
Pneumonia complications
Prone Position
Respiratory Distress Syndrome physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 0929-6646
- Volume :
- 106
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of the Formosan Medical Association = Taiwan yi zhi
- Publication Type :
- Academic Journal
- Accession number :
- 17908660
- Full Text :
- https://doi.org/10.1016/S0929-6646(08)60032-7