Lung ultrasonography for assessment of oxygenation response to prone position ventilation in ARDS

Purpose Prone position (PP) improves oxygenation and outcome of acute respiratory distress syndrome (ARDS) patients with a PaO.sub.2/FiO.sub.2 ratio Methods We conducted a prospective multicenter study that included adult patients with severe and moderate ARDS. LUS data were collected at four time points: 1 h before (baseline) and 1 h after turning the patient to PP, 1 h before and 1 h after turning the patient back to the supine position. Regional lung aeration changes and ultrasound reaeration scores were assessed at each time. Overdistension was not assessed. Results Fifty-one patients were included. Oxygenation response after PP was not correlated with a specific LUS pattern. The patients with focal and non-focal ARDS showed no difference in global reaeration score. With regard to the entire PP session, the patients with non-focal ARDS had an improved aeration gain in the anterior areas. Oxygenation response was not associated with aeration changes. No difference in PaCO.sub.2 change was found according to oxygenation response or lung morphology. Conclusions In ARDS patients with a PaO.sub.2/FiO.sub.2 ratio [less than or equal to]150 mmHg, bedside LUS cannot predict oxygenation response after the first PP session. At the bedside, LUS enables monitoring of aeration changes during PP.
Author(s): Malik Haddam [sup.1] , Laurent Zieleskiewicz [sup.1] , Sebastien Perbet [sup.2] , Alice Baldovini [sup.1] , Christophe Guervilly [sup.3] , Charlotte Arbelot [sup.4] , Alexandre Noel [sup.5] , Coralie [...]