Effect of prone position ventilation on right heart function in patients with acute respiratory distress syndrome

Lu, Huaihai; Zhang, Pei; Liu, Xuefang; Jin, Liwei; Zhu, He

doi:10.1111/crj.13431

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…This can be attributed to the self-efficacy intervention received by patients in the intervention group during the awake prone positioning ventilation. Most patients in this study were elderly with low physical tolerance and low education levels, and had limited skills in performing the awake prone positioning ventilation technique [12]. In the control group, most patients were unable to persist with the therapy for more than half an hour due to changes in body position, resulting in large fluctuations in SpO 2 and increased RR.…”

Section: Discussionmentioning

confidence: 96%

Incorporating Self-Efficacy Theory to Awake Prone Positioning in COVID-19 Patients: A Single-Center Perspective Study

Wang¹,

Kuang²,

yang³

et al. 2023

MRHK

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Objective: This study sought to examine whether the inclusion of self-efficacy theory could increase the effectiveness of awake prone positioning in COVID-19 patients. Method: A total of 80 COVID-19 patients admitted to the respiratory department of our hospital between December 2022 and February 2023 were randomly allocated into either the intervention group (n=40) or the control group (n=40). The control group received routine respiratory medicine treatment and underwent awake prone positioning, whereas the intervention group received additional self-efficacy theory intervention alongside awake prone positioning. The patients’ oxygen saturation level (SpO2) and respiratory rate (RR) were closely monitored at three different time points: before awake prone positioning, 30 minutes and 1 hour after awake prone positioning. Furthermore, the patients’ Modified Medical Research Council (mMRC) dyspnea scale and self-efficacy scores were evaluated on the first, second, and third days of awake prone positioning. The cumulative duration of awake prone positioning and patient satisfaction were recorded on the third day of the intervention. Results: The data indicate that the intervention group demonstrated significant improvements in both SpO2 and RR compared to the control group, both at 1 hour and at the end of awake prone positioning (P＜0.05). Moreover, the intervention group experienced a substantial reduction in the dyspnea index compared to the control group on the second and third day (P＜0.05). The intervention group also reported higher self-efficacy scores, cumulative duration of awake prone positioning ventilation on the third day, and satisfaction levels compared to the control group on the first, second, and third day (P<0.05). Conclusions: The incorporation of self-efficacy theory to awake prone positioning improves the short-term outcomes of COVID-19 patients. This patient-centered approach has the potential to increase patients’ self-efficacy and satisfaction levels, emphasizing the importance of incorporating patient-centered care in healthcare practices.

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Section: Discussionmentioning

confidence: 96%

Incorporating Self-Efficacy Theory to Awake Prone Positioning in COVID-19 Patients: A Single-Center Perspective Study

Wang¹,

Kuang²,

yang³

et al. 2023

MRHK

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“…Theoretically, combining ECMO with PPV may offer enhanced lung protection, observable through metrics such as PaO 2 /FiO 2 , OI, respiratory system compliance (Crs), airway resistance (RAW), among others. While prior studies have explored the synergistic potential of these two interventions, limited research specifically addresses the combined use of PPV and ECMO in neonatal patients ( 14 , 15 ). This study retrospectively analyzes clinical data from neonates who were provided ECMO support at our hospital from June 2021 to June 2023, aiming to evaluate the effectiveness and safety of integrating PPV with ECMO in the treatment regimen for these patients.…”

Section: Introductionmentioning

confidence: 99%

Effect of prone positioning ventilation on pulmonary function in neonates during venous-arterial extracorporeal membrane oxygenation

Sun,

Zhou,

Chen

et al. 2024

Transl Pediatr

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Background The use of extracorporeal membrane oxygenation (ECMO) technology has significantly decreased mortality rates associated with neonatal pulmonary hypertension and respiratory failure. Prone positioning ventilation (PPV) is a commonly used technique in critically ill infants, designed to improve thoracic pressure gradients, re-expand dorsal lung segments, and increase oxygenation in approximately 70–80% of patients suffering from acute respiratory distress syndrome. This study aimed to evaluate the effects of PPV on pulmonary function in neonates undergoing venous-arterial extracorporeal membrane oxygenation (VA-ECMO). Methods We conducted a retrospective analysis of clinical data from 17 neonates who received ECMO support in our institution, divided into two groups based on ventilation strategy: ECMO with PPV (ECMO-PPV, n=8) and ECMO with supine positioning ventilation (ECMO-SPV, n=9). Parameters such as the P/F ratio [arterial oxygen partial pressure (PaO 2 )/fraction of inspired oxygen (FiO 2 )], oxygenation index (OI), respiratory system compliance (Crs), and airway resistance (RAW) were collected and analyzed at baseline, and at 1, 2, and 3 days post-ECMO initiation. In the ECMO-PPV group, these parameters were also assessed 3 days pre-treatment and 2 hours post-treatment initiation. Results Initial comparisons between ECMO-PPV and ECMO-SPV groups showed no significant difference in PaO 2 /FiO 2 , OI, Crs, or RAW. Throughout the ECMO treatment, both groups demonstrated gradual improvements in PaO 2 /FiO 2 and Crs, and reductions in OI and RAW. Notably, by day 3, the ECMO-PPV group exhibited significant improvements in Crs and RAW compared to the ECMO-SPV group (P<0.05). Specifically, in the ECMO-PPV group, Crs significantly increased and RAW decreased after 2 hours of initiating PPV, with these changes becoming statistically significant by day 3 (Crs P=0.03, RAW P=0.03). No severe PPV-related complications were noted. Conclusions PPV during neonatal ECMO may improve respiratory compliance and reduce RAW, potentially aiding lung recovery. Our findings suggest PPV as a viable strategy for neonates under ECMO support.

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“…In addition, Liu et al (Liu et al, 2018) pointed out that the prone ventilation treatment rate of patients with severe ARDS in China was only 8.7%, and the high complication rate and low compliance were related to the lack of standardised surgical procedures. In recent years, clinical studies on PPV have mainly focused on the application effect of PPV in different populations and diseases and the analysis of its haemodynamic effect on patients (Huang et al, 2021;Lu et al, 2021). Nursing studies are mostly fragments of experience or summary, and there is still a lack of standard preventive measures and management plans for the whole process, not to say, related nursing guidelines or expert consensus to standardise the implementation of clinical PPV.…”

Section: Introductionmentioning

confidence: 99%

Construction and application of prone position ventilation management scheme for severe COVID-19 patients

Chen,

Peng,

Xiao

et al. 2023

Front. Physiol.

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Background: Prone position ventilation (PPV) can significantly improve oxygenation index and blood oxygen saturation in most (70%–80%) patients with acute respiratory distress syndrome. However, although PPV is not an invasive procedure, there are many potential PPV-related complications, such as nerve compression, crush injury, venous stasis (e.g., facial oedema), pressure sores, retinal damage, vomiting, and arrhythmia, with an incidence of up to 56.9%. Nursing managers have focused on reducing the occurrence of PPV-related complications and improving safety.Objective: To construct a prone ventilation management scheme for patients with severe coronavirus disease 2019 (COVID–19) and analyse its application effect.Methods: Based on a previous evidence-based study combined with the COVID-19 Diagnosis and Treatment Protocol (Trial Edition 9), a prone ventilation management protocol for severe COVID-19 was formulated and applied to COVID-19 patients in the intensive care unit of a designated hospital. A prospective self-control study was used to compare changes in the oxygenation index and other outcome indicators before and after the intervention.Results: The oxygenation index of patients after intervention (321.22 ± 19.77 mmHg) was significantly higher (p < 0.05) than before intervention (151.59 ± 35.49 mmHg). The difference in oxygenation index in different prone position ventilation durations was statistically significant (p < 0.05). Nursing quality evaluation indicators showed that the implementation rate of gastric residual volume assessment was 100% and the incidence of occupational exposure and cross-infection was 0%; the incidences of pressure ulcers, drug extravasation, and facial oedema were 13.64% (3/22), 4.54% (1/22), and 4.54% (1/22), respectively. The incidence of unplanned extubation, aspiration, and falls/falls was 0%.

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Effect of prone position ventilation on right heart function in patients with acute respiratory distress syndrome

Cited by 5 publications

References 24 publications

Incorporating Self-Efficacy Theory to Awake Prone Positioning in COVID-19 Patients: A Single-Center Perspective Study

Incorporating Self-Efficacy Theory to Awake Prone Positioning in COVID-19 Patients: A Single-Center Perspective Study

Effect of prone positioning ventilation on pulmonary function in neonates during venous-arterial extracorporeal membrane oxygenation

Construction and application of prone position ventilation management scheme for severe COVID-19 patients

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