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Intensive Care Medicine

, Volume 38, Issue 2, pp 221–229 | Cite as

Long-term outcomes in survivors of acute respiratory distress syndrome ventilated in supine or prone position

  • D. ChiumelloEmail author
  • P. Taccone
  • V. Berto
  • A. Marino
  • G. Migliara
  • M. Lazzerini
  • L. Gattinoni
Original

Abstract

Purpose

The aim of this study is to examine long-term pulmonary function and quality of life in survivors of acute respiratory distress syndrome (ARDS) previously enrolled in a randomized multicenter trial testing prone compared with supine positioning (PSII study) at five Italian centers.

Design

Observational prospective study.

Subjects and measurements

Pulmonary function [spirometric test, gas exchange, carbon monoxide diffusion capacity (DLCO)], high-resolution computed tomography (CT) scan, and health-related quality of life [Short Form-36 (SF-36) and St. George’s Respiratory Questionnaire] were evaluated at 12 months.

Results

Twenty-six patients (13 in each group, mean age 54.1 ± 2.8 years, body mass index 24.5 ± 1.4 kg/m2, PaO2/FiO2 117 ± 49 mmHg) were evaluated. There were no significant differences in demographic data, illness severity, or outcome between the prone and supine groups. The overall survival rate was 40%. Pulmonary function was in the normal range without any differences between the two groups. Quantitative lung CT scan analysis showed similar amounts for not aerated (8.1 ± 3.2% versus 7.3 ± 3.4%), poorly aerated (15.3 ± 3.6% versus 17.1 ± 4.9%), and well-aerated (64.0% ± 8.4 versus 70.2 ± 8.4%) lung regions, while overaerated lung region was slightly higher in the prone compared with the supine group (12.5 ± 6.5% versus 5.3 ± 5.5%). Health-related quality of life was similar to in healthy population. However, these patients showed reduction in daily activity specifically due to pulmonary disease as measured by the St. George’s Respiratory Questionnaire.

Conclusions

No differences in pulmonary function or quality of life were observed in this small group of ARDS survivor patients treated in prone versus supine position.

Keywords

ARDS Prone positioning Health-related quality of life Pulmonary function Outcome 

Notes

Acknowledgments

KCI supports the secretarial activity of the coordinating center

Conflicts of interest

Dr Gattinoni has been a member of KCI Medical Products advisory board. The other authors reported no financial disclosures.

Supplementary material

134_2011_2445_MOESM1_ESM.doc (50 kb)
Supplementary material 1 (DOC 50 kb)

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Copyright information

© Copyright jointly held by Springer and ESICM 2011

Authors and Affiliations

  • D. Chiumello
    • 1
    Email author
  • P. Taccone
    • 1
  • V. Berto
    • 1
  • A. Marino
    • 2
  • G. Migliara
    • 3
  • M. Lazzerini
    • 4
  • L. Gattinoni
    • 1
  1. 1.Dipartimento di Anestesia, Rianimazione (Intensiva e Subintensiva) e Terapia del DoloreFondazione IRCCS Ca’ Granda-Ospedale Maggiore PoliclinicoMilanItaly
  2. 2.Dipartimento di Anestesiologia, Terapia Intensiva e Scienze DermatologicheUniversità degli Studi di MilanoMilanItaly
  3. 3.Dipartimento Toraco-Polmonare e Cardio-CircolatorioFondazione IRCCS Ca’ Granda-Ospedale Maggiore PoliclinicoMilanItaly
  4. 4.Dipartimento di RadiologiaFondazione IRCCS Ca’ Granda-Ospedale Maggiore PoliclinicoMilanItaly

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