Awake prone positioning in acute hypoxaemic respiratory failure
| Autor: | Bairbre A. McNicholas, Miguel Ibarra-Estrada, Yonatan Perez, Jie Li, Ivan Pavlov, Aileen Kharat, David L. Vines, Oriol Roca, David Cosgrave, Claude Guerin, Stephan Ehrmann, John G. Laffey |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | European Respiratory Review, Vol 32, Iss 168 (2023) |
| Druh dokumentu: | article |
| ISSN: | 0905-9180 1600-0617 16000617 |
| DOI: | 10.1183/16000617.0245-2022 |
| Popis: | Awake prone positioning (APP) of patients with acute hypoxaemic respiratory failure gained considerable attention during the early phases of the coronavirus disease 2019 (COVID-19) pandemic. Prior to the pandemic, reports of APP were limited to case series in patients with influenza and in immunocompromised patients, with encouraging results in terms of tolerance and oxygenation improvement. Prone positioning of awake patients with acute hypoxaemic respiratory failure appears to result in many of the same physiological changes improving oxygenation seen in invasively ventilated patients with moderate–severe acute respiratory distress syndrome. A number of randomised controlled studies published on patients with varying severity of COVID-19 have reported apparently contrasting outcomes. However, there is consistent evidence that more hypoxaemic patients requiring advanced respiratory support, who are managed in higher care environments and who can be prone for several hours, benefit most from APP use. We review the physiological basis by which prone positioning results in changes in lung mechanics and gas exchange and summarise the latest evidence base for APP primarily in COVID-19. We examine the key factors that influence the success of APP, the optimal target populations for APP and the key unknowns that will shape future research. |
| Databáze: | Directory of Open Access Journals |
| Externí odkaz: |
|