医学
仰卧位
急性呼吸窘迫综合征
俯卧位
麻醉
肺不张
通风(建筑)
重症监护室
呼吸生理学
呼吸窘迫
心脏外科
动脉血
呼吸系统
肺
心脏病学
内科学
机械工程
工程类
作者
Yujie Zhang,Wang-Tao Zhou,Jing Ma
标识
DOI:10.1177/02676591241228972
摘要
Background This study aimed to investigate the effects of prone position ventilation treatment on patients with acute respiratory distress syndrome (ARDS) after cardiac surgery. Methods Clinical data were collected from 93 hospitalized patients with acute respiratory distress syndrome (ARDS) in the intensive care unit (ICU) of cardiology from February 2021 to February 2023. Patients were divided into supine position group ( n = 45) and prone position group ( n = 48). The difference in 28-days survival rates, blood gas indicators, respiratory mechanics indicators, and adverse events before and after treatment was analyzed. Results We found that within 28 days of admission, 8.33% of ARDS patients in prone position group and 11.11% in supine position group died of all causes ( p > .05). After treatment, the levels of arterial PaO 2 (103.25 ± 9.44 in prone position group and 91.62 ± 9.18 in supine position group), PaCO 2 (30.26 ± 5.54 and 36.56 ± 6.37), blood LAC (1.35 ± 0.37 and 1.68 ± 0.42), oxygenation (232.23 ± 28.56 and 205.13 ± 31.34) and diffusion index (453.48 ± 63.30 and 395.18 ± 58.54) in both groups were improved ( p < .001). Moreover, the increase in prone position group was more remarkable. After treatment, the respiratory mechanics indexes of the lung compliance as well as respiratory resistance were improved ( p < .05). Moreover, the increase in supine position group was more remarkable ( p < .05). The incidence of atelectasis in prone position group was lower than that in supine position group ( p < .05). Additionally, the alteration in other adverse events showed no significant difference between the two groups ( p > .05). Conclusions Taken together, prone position ventilation in patients with ARDS after cardiac surgery improved blood gas indexes, hypoxemia, and respiratory mechanics indexes, as well as reduced the incidence of atelectasis.
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