Your browser doesn't support javascript.
loading
Prone positioning before extracorporeal membrane oxygenation for severe acute respiratory distress syndrome: A retrospective multicenter study / Decúbito prono previo a la oxigenación de membrana extracorpórea para el síndrome de dificultad respiratoria aguda: un estudio retrospectivo multicéntrico
Kim, WY; Kang, BJ; Chung, CR; Park, SH; Oh, JY; Park, SY; Cho, WH; Sim, YS; Cho, YJ; Park, S; Kim, JH; Hong, SB.
Afiliação
  • Kim, WY; Pusan National University School of Medicine. Department of Internal Medicine. Division of Pulmonary, Allergy and Critical Care Medicine. Busan. Republic of Korea
  • Kang, BJ; University of Ulsan College of Medicine. Ulsan University Hospital. Department of Internal Medicine. Ulsan. Republic of Korea
  • Chung, CR; Sungkyunkwan University School of Medicine. Samsung Medical Center. Department of Critical Care Medicine. Seoul. Republic of Korea
  • Park, SH; Kyung Hee University School of Medicine. Kyung Hee University Hospital at Gangdong. Department of Pulmonary and Critical Care Medicine. Seoul. Republic of Korea
  • Oh, JY; Dongguk University College of Medicine. Dongguk University Ilsan Hospital. Division of Pulmonology and Critical Care Medicine. Goyang. Republic of Korea
  • Park, SY; Chonbuk National University Medical School. Department of Internal Medicine. Jeonju. Republic of Korea
  • Cho, WH; Pusan National University Yangsan Hospital. Department of Pulmonology and Critical Care Medicine. Yangsan. Republic of Korea
  • Sim, YS; Hallym University Kangnam Sacred Heart Hospital. Department of Medicine. Division of Pulmonary and Critical Care Medicine. Seoul. Republic of Korea
  • Cho, YJ; Seoul National University College of Medicine. Seoul National University Bundang Hospital. Department of Internal Medicine. Division of Pulmonary and Critical Care Medicine. Seongnam. Republic of Korea
  • Park, S; Hallym University Sacred Heart Hospital. Department of Medicine. Division of Pulmonary and Critical Care Medicine. Anyang. Republic of Korea
  • Kim, JH; CHA University School of Medicine. CHA Bundang Medical Center. Department of Internal Medicine. Seongnam. Republic of Korea
  • Hong, SB; University of Ulsan College of Medicine. Asan Medical Center. Department of Pulmonary and Critical Care Medicine. Seoul. Republic of Korea
Med. intensiva (Madr., Ed. impr.) ; 43(7): 402-409, oct. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-185867
Biblioteca responsável: ES1.1
Localização: BNCS
ABSTRACT

Objective:

To evaluate the clinical outcomes of patients with severe acute respiratory distress syndrome (ARDS) subjected to prone positioning before extracorporeal membrane oxygenation (ECMO).

Design:

A retrospective analysis of a multicenter cohort was carried out.

Setting:

Patients admitted to the Intensive Care Units of 11 hospitals in Korea. Patients Patients were divided into those who underwent prone positioning before ECMO (n=28) and those who did not (n=34).

Interventions:

None. Variables of interest Thirty-day mortality, ECMO weaning failure rate, mechanical ventilation weaning success rate, mechanical ventilation-free days at day 60.

Results:

The prone group had lower median peak inspiratory pressure and lower median dynamic driving pressure before ECMO. Thirty-day mortality was 21% in the prone group and 41% in the non-prone group (p=0.098). The prone group also showed a lower ECMO weaning failure rate, and a higher mechanical ventilation weaning success rate and more mechanical ventilation-free days at day 60. In the non-prone group, median dynamic compliance marginally decreased shortly after ECMO, but no significant change was observed in the prone group.

Conclusions:

Prone positioning before ECMO was not associated to increased mortality and tended to exert a protective effect
RESUMEN

Objetivo:

Evaluar los resultados clínicos de pacientes con síndrome de dificultad respiratoria aguda (SDRA) quienes fueron colocados en decúbito prono previo a la oxigenación con membrana extracorpórea (ECMO).

Diseño:

Análisis retrospectivo de una cohorte multicéntrico. Escenario Pacientes admitidos en las unidades de cuidado intensivo de 11 hospitales en Corea. Pacientes Los pacientes fueron divididos en aquellos que fueron colocados en decúbito prono antes de la ECMO (n=28) y aquellos que no fueron colocados en decúbito prono antes de la ECMO (n=34). Intervenciones Ninguna. Variables de interés principales Mortalidad a los 30 días, tasa de fracaso de retirada gradual de la ECMO, tasa de éxito de retirada gradual de la ventilación mecánica, días sin ventilación mecánica a los 60 días.

Resultados:

El grupo prono tuvo una mediana más baja de la presión inspiratoria máxima y una mediana más baja de la presión de conducción dinámica antes de la ECMO. La mortalidad a los 30 días fue 21% en el grupo prono y 41% en el grupo no prono (P = 0.098). El grupo prono también mostró un valor numérico menor de tasa de fracaso de retirada progresiva de la ECMO, y valores más altos de tasa de éxito de destete de la ventilación mecánica y días sin ventilación mecánica a los 60 días. En el grupo no prono, la mediana del cumplimiento dinámico descendió marginalmente, poco después de ECMO, pero no se observó un cambio significativo en el grupo prono.

Conclusiones:

La colocación en decúbito prono antes de la ECMO no se asoció con un incremento en mortalidad y tendió a ser de protección
Assuntos

Texto completo: Disponível Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Síndrome do Desconforto Respiratório / Oxigenação por Membrana Extracorpórea / Estudos de Coortes / Decúbito Ventral / Posicionamento do Paciente Limite: Humanos Idioma: Inglês Revista: Med. intensiva (Madr., Ed. impr.) Ano de publicação: 2019 Tipo de documento: Artigo Instituição/País de afiliação: CHA University School of Medicine/Republic of Korea / Chonbuk National University Medical School/Republic of Korea / Dongguk University College of Medicine/Republic of Korea / Hallym University Kangnam Sacred Heart Hospital/Republic of Korea / Hallym University Sacred Heart Hospital/Republic of Korea / Kyung Hee University School of Medicine/Republic of Korea / Pusan National University School of Medicine/Republic of Korea / Pusan National University Yangsan Hospital/Republic of Korea / Seoul National University College of Medicine/Republic of Korea / Sungkyunkwan University School of Medicine/Republic of Korea

Texto completo: Disponível Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Síndrome do Desconforto Respiratório / Oxigenação por Membrana Extracorpórea / Estudos de Coortes / Decúbito Ventral / Posicionamento do Paciente Limite: Humanos Idioma: Inglês Revista: Med. intensiva (Madr., Ed. impr.) Ano de publicação: 2019 Tipo de documento: Artigo Instituição/País de afiliação: CHA University School of Medicine/Republic of Korea / Chonbuk National University Medical School/Republic of Korea / Dongguk University College of Medicine/Republic of Korea / Hallym University Kangnam Sacred Heart Hospital/Republic of Korea / Hallym University Sacred Heart Hospital/Republic of Korea / Kyung Hee University School of Medicine/Republic of Korea / Pusan National University School of Medicine/Republic of Korea / Pusan National University Yangsan Hospital/Republic of Korea / Seoul National University College of Medicine/Republic of Korea / Sungkyunkwan University School of Medicine/Republic of Korea
...