Prone positioning in severe ARDS requiring extracorporeal membrane oxygenation

Autor: Jonathan Rilinger, Viviane Zotzmann, Xavier Bemtgen, Carin Schumacher, Paul M. Biever, Daniel Duerschmied, Klaus Kaier, Peter Stachon, Constantin von zur Mühlen, Manfred Zehender, Christoph Bode, Dawid L. Staudacher, Tobias Wengenmayer
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Critical Care, Vol 24, Iss 1, Pp 1-9 (2020)
Druh dokumentu: article
ISSN: 1364-8535
DOI: 10.1186/s13054-020-03110-2
Popis: Abstract Background Prone positioning (PP) has shown to improve survival in patients with severe acute respiratory distress syndrome (ARDS). To this point, it is unclear if PP is also beneficial for ARDS patients treated with veno-venous extracorporeal membrane oxygenation (VV ECMO) support. Methods We report retrospective data of a single-centre registry of patients with severe ARDS requiring VV ECMO support between October 2010 and May 2018. Patients were allocated to the PP group if PP was performed during VV ECMO treatment or the supine positioning group. VV ECMO weaning success and hospital survival were analysed before and after propensity score matching. Results A total of 158 patients could be analysed, and 38 patients (24.1%) received PP. There were no significant differences in VV ECMO weaning rate (47.4% vs. 46.7%, p = 0.94) and hospital survival (36.8% vs. 36.7%, p = 0.98) between the prone and supine groups, respectively. The analysis of 38 propensity score matched pairs also showed no difference in hospital survival (36.8% vs. 36.8%, p = 1.0) or VV ECMO weaning rate (47.4% vs. 44.7%, p = 0.82). Hospital survival was superior in the subgroup of patients treated with early PP (cutoff
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