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Patient Posture
Because the prone position increases the homogeneity of lung inflation, Pelosi and coworkers
determined whether a sigh causes greater recruitment in the prone position than in the supine position. In 10 patients with ARDS, three consecutive sighs (increase in plateau pressure to 45 cm H2O) increased PO2 more in the prone position than in the supine position (37 versus 16 mm Hg), and the sighs also increased end-expiratory lung volume more in the prone position than in the supine position (277 versus 68 ml). Improvement was sustained for one hour after discontinuation of the sighs. The increase in PO2 with sighs was correlated with the change in end-expiratory lung volume (r = 0.82). The authors conclude that the recruitment effect of sighs is greater in the prone position than in the supine position.
1 Citation displayed.
Sigh in Supine and Prone Position during Acute Respiratory Distress Syndrome
- Paolo Pelosi, Nicola Bottino, Davide Chiumello, Pietro Caironi, Mauro Panigada, Chiara Gamberoni, Giorgia Colombo, Luca M. Bigatello, and Luciano Gattinoni
Am. J. Respir. Crit. Care Med. 167: 521 -527. First published online as doi:10.1164/rccm.200203-198OC
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