Effect of body position and inclination in supine and prone position on respiratory mechanics in acute respiratory distress syndrome
The mechanism by which prone position (PP) reduces mortality in moderate-to-severe acute respiratory distress syndrome (ARDS) patients as compared to supine (SP)  likely includes reduction/homogenization of lung stress/strain. The common accepted scenario is that this effect stems from an increase in chest wall elastance (Est,cw) in PP. However, whether, and to what extent, the angulation of the body may affect Est,cw is unclear. Our hypothesis is that thorax inclination significantly changes respiratory system mechanics and lung volume from SP to PP, as previously suggested in healthy humans  and anesthetized patients .
The present report is an ancillary study of a previous published work . In ARDS patients receiving continuous infusion of sedative and neuromuscular blockade agents, lung and chest wall mechanics, end-expiratory lung volume (EELV), and transcutaneous oxygen saturation (SpO2) were measured in the following order: SP 30° head-up (SP30°),...
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Conflicts of interest
The authors declare no conflict of interest.
- 1.Guerin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T, Mercier E, Badet M, Mercat A, Baudin O, Clavel M, Chatellier D, Jaber S, Rosselli S, Mancebo J, Sirodot M, Hilbert G, Bengler C, Richecoeur J, Gainnier M, Bayle F, Bourdin G, Leray V, Girard R, Baboi L, Ayzac L, PROSEVA Study Group (2013) Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 368:2159–2168CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Mezidi M, Parrilla FJ, Yonis H, Riad Z, Bohm SH, Waldmann AD, Richard JC, Lissonde F, Tapponnier R, Baboi L, Mancebo J, Guerin C (2018) Effects of positive end-expiratory pressure strategy in supine and prone position on lung and chest wall mechanics in acute respiratory distress syndrome. Ann Intensive Care 8:86CrossRefPubMedPubMedCentralGoogle Scholar