| Autor: |
Frick, Anna Elisabeth, Schiefer, Judith, Maleczek, Mathias, Schwarz, Stefan, Benazzo, Alberto, Rath, Anna, Kulu, Askin, Hritcu, Richard, Faybik, Peter, Schaden, Eva, Jaksch, Peter, Tschernko, Edda, Frommlet, Florian, Markstaller, Klaus, Hoetzenecker, Konrad |
| Zdroj: |
Annals of Thoracic Surgery; May2024, Vol. 117 Issue 5, p1045-1051, 7p |
| Abstrakt: |
Prone positioning has become a standard therapy in acute respiratory distress syndrome to improve oxygenation and decrease mortality. However, little is known about prone positioning in lung transplant recipients. This large, singe-center analysis investigated whether prone positioning improves gas exchange after lung transplantation. Clinical data of 583 patients were analyzed. Prone position was considered in case of impaired gas exchange Pa o 2 /fraction of oxygen in inhaled air (<250), signs of edema after lung transplantation, and/or evidence of reperfusion injury. Patients with hemodynamic instability or active bleeding were not proned. Impact of prone positioning (n = 165) on gas exchange, early outcome and survival were determined and compared with patients in supine positioning (n = 418). Patients in prone position were younger, more likely to have interstitial lung disease, and had a higher lung allocation score. Patients were proned for a median of 19 hours (interquartile range,15-26) hours). They had significantly lower Pa o 2 /fraction of oxygen in inhaled air (227 ± 96 vs 303 ± 127 mm Hg, P =.004), and lower lung compliance (24.8 ± 9.1 mL/mbar vs 29.8 ± 9.7 mL/mbar, P <.001) immediately after lung transplantation. Both values significantly improved after prone positioning for 24 hours (Pa o 2 /fraction of oxygen ratio: 331 ± 91 mm Hg; lung compliance: 31.7 ± 20.2 mL/mbar). Survival at 90 days was similar between the 2 groups (93% vs 96%, P =.105). Prone positioning led to a significant improvement in lung compliance and oxygenation after lung transplantation. Prospective studies are needed to confirm the benefit of prone positioning in lung transplantation. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Supplemental Index |
| Externí odkaz: |
|
