医学
急性呼吸窘迫
急性呼吸窘迫综合征
俯卧位
机械通风
呼吸窘迫
重症监护医学
麻醉
苦恼
急诊医学
作者
Anna N. Breiburg,Leanne M. Aitken,Linda L. Reaby,Richard L. Clancy,Janet D. Pierce
标识
DOI:10.1046/j.1365-2648.2000.t01-1-01557.x
摘要
Efficacy and safety of prone positioning for patients with acute respiratory distress syndrome
This article presents an overview of a literature review on how prone positioning can alleviate pathophysiological changes in ARDS and improve ventilation and perfusion. Improvement of gas exchange, efficiency of oxygenation and lung function are emphasized. Literature on the pathophysiology of ARDS, and the physiological effects of prone positioning on haemodynamics and lung function is examined. There are both advantages and disadvantages in turning a patient from the supine to the prone position. There are also contraindications in rotating between the supine and prone positions. Nevertheless, by rotating patients with ARDS, it is possible to achieve a significant improvement in A-aDO2, decrease shunting, and therefore improve oxygenation without use of expensive, invasive and experimental procedures. Placing patients with ARDS in the prone position can reduce inspiratory oxygen concentrations and peak inspiratory pressures, which minimizes the chance for barotrauma and the iatrogenic effects of hyperventilation oxygen toxicity.
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