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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Chao, Yali Yuan, Xueyan Zhao, Zhanqi Frerichs, Inéz Li, Zhe Sun, Qin Chen, Dongyu Zhang, Rui Qiu, Haibo Liu, Ling |
| Abstract | Background Prone positioning (PP) improves oxygenation in awake patients with acute hypoxemic respiratory failure (AHRF). However, the underlying mechanisms remain unclear in patients with diverse lung morphology. We aimed to determine the short-term effects of awake prone positioning (APP) in AHRF patients with focal and non-focal lung morphology. Methods This is a prospective physiological study. Twenty-four non-intubated patients with PaO2/FiO2 ≤ 300 mm Hg were included. Gas exchange, ventilation and perfusion distribution, and hemodynamics variables were recorded in the supine position (SP1), 2 h after PP, and 1 h after re-supine (SP2). Lung morphology was classified as focal and non-focal patterns using computed tomography. Results Twelve of the included patients were classified to the focal group and 12 to the non-focal group. PaO2/FiO2 improved after PP in all patients (161 [137, 227] mmHg vs. 236 [202, 275] mmHg, p < 0.001). Ventilation-perfusion (V/Q) matching increased after PP in all patients (61.9 [53.9, 66.5] vs. 77.5 [68.3, 80.0], p < 0.001). Shunt exhibited a significant decrease in patients of the non-focal group (28.6 [22.5, 30.3] vs. 11.3 [9.0, 14.5], p < 0.001), whereas no difference was found in the focal group after PP. Dead space decreased significantly in patients of the focal group (25.6 [21.5, 28.4] vs. 12.0 [10.8, 14.1], p < 0.001), whereas no difference was found in the non-focal group after PP. Conclusions APP improves V/Q matching, and large-scale, bias-free studies are needed to find more definitive differences between patients with focal and non-focal lung morphyology. Trial registration The study is registered in ClinicalTrials.gov (trial No. NCT04754113, date of registration: 2021-02-15). |
| Related Links | https://bmcpulmmed.biomedcentral.com/counter/pdf/10.1186/s12890-024-03411-0.pdf |
| Ending Page | 8 |
| Page Count | 8 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14712466 |
| DOI | 10.1186/s12890-024-03411-0 |
| Journal | BMC Pulmonary Medicine |
| Issue Number | 1 |
| Volume Number | 24 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2024-12-04 |
| Access Restriction | Open |
| Subject Keyword | Pneumology Respiratory System Internal Medicine Intensive Critical Care Medicine Awake prone positioning Ventilation-perfusion matching Shunt Dead space Acute hypoxemic respiratory failure Pneumology/Respiratory System |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine |
| Journal Impact Factor | 2.6/2023 |
| 5-Year Journal Impact Factor | 3/2023 |
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