Open AccessProne position ventilation support for acute exacerbation of interstitial lung disease?
Author(s) -
Xu Yuanda,
Sun Qingwen,
Yu Yuheng,
Liang Weibo,
Liu Xuesong,
Yang Chun,
Xu Yonghao,
g Lingbo,
Chen Sibei,
He Weiqun,
Liu Xiaoqing,
Li Yimin,
Zhong Nanshan
Publication year - 2018
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12665
Subject(s) - medicine , ards , exacerbation , oxygenation , mechanical ventilation , ventilation (architecture) , cardiac index , prone position , diffuse alveolar damage , cardiology , anesthesia , acute respiratory distress , hemodynamics , lung , cardiac output , mechanical engineering , engineering
Prone position ventilation (PPV) has been shown to improve oxygenation and decrease pulmonary vascular resistance and mortality in patients with severe acute respiratory distress syndrome (ARDS). Whether these benefits of PPV occur similarly in acute exacerbations of interstitial lung disease (ILD) is not clear. We retrospectively explored the use of PPV in acute exacerbation with ILD versus those with severe acute respiratory distress syndrome (severe ARDS). Methods Retrospective study of the application of PPV in 17 patients with acute exacerbations of ILD and in 19 patients with severe ARDS. Pre‐ and post‐PPV hemodynamic parameters, respiratory mechanics, prognostic indicators, complications and mortality rates at 28, 60 and 90 days were compared. Results There was no difference in baseline characteristics between the two groups except for higher driving pressure and more diastolic dysfunction in ILD group than severe ARDS group Compared with pre‐PPV, cardiac index and driving pressure remained unchanged post‐PPV in both groups. PPV increased PaO 2 /FiO 2 [118.7 (92.0, 147.8) pre‐PPV vs 132.0 (93.5, 172.0) post‐PPV; P < 0.05] and central venous oxygenation in patients with ILD. In patients with severe ARDS, PPV significantly increased PaO 2 /FiO 2 [109.23 (89,135) pre‐ PPV vs 126.13 (100.93, 170) post‐PPV; P < 0.05] and intrathorax blood volume index. However, mortality rates at 28, 60 and 90 days remained high in both groups (76.4%, 88.2% and 88.2% vs 36.8%, 57.9% and 57.9% in ILD and severe ARDS, respectively; P < 0.05). Conclusion Our findings suggest that PPV may improve oxygenation and partially improve hemodynamic parameters during acute exacerbations of ILD.