Initial evaluation of the effectiveness of prone position ventilation for treating acute respiratory distress syndrome in patients with severe burns
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Abstract
Introduction: In patients with severe ARDS, prone-position ventilation is thought to be effective in improving air exchange and safe.
Objectives: To evaluate the effectiveness of improving blood oxygenation and lung mechanics after prone position ventilation, the safety of the treatment, and its outcomes.
Subjects and methods: A prospective comparative study was conducted on 14 adult burn patients with ARDS, treated in the Intensive care unit at the National Burn Hospital, from 8/2021 to 10/2022. Indicators include blood oxygenation; lung mechanics before, during, and after prone position ventilation. Clinical criteria: Accidents, complications during the ventilation process, and the outcomes of prone position ventilation.
Results: The average burn area was 53.92 ± 21.05%, mean deep burn area was 27.07 ± 14.75%. There were six out of 14 patients with an inhalation injury. During the prone position ventilation process, blood oxygenation improved over time, and the PaO2/FiO2 ratio increased gradually compared with before ventilation (p < 0.05). Static lung compliance increased sharply after prone-position ventilation, from 22.5 ml/cmH2O to 25.36 ml/cmH2O (p < 0.05). Peak airway pressure, plateau pressure, and mean airway pressure decreased significantly after prone position ventilation (p < 0.05). Prone position ventilation was quite safe: no patients underwent hypotension, cardiac arrest, endotracheal tube obstruction, or slip of the endotracheal tube; one patient had a slip of a central venous catheter (7.14%), and six patients had facial edema (42.84%). The rate of improved oxygenation in patients was high (85.72%), and the mortality rate was 64.3%.
Conclusion: Prone position ventilation was effective in improving blood oxygenation, and lung mechanics and safe for patients with severe ARDS.
Article Details
Keywords
Prone position ventilation, burns, ARDS
References
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