Prone positioning before extracorporeal membrane oxygenation for severe acute respiratory distress syndrome: A retrospective multicenter study.
Med Intensiva (Engl Ed)
; 43(7): 402-409, 2019 Oct.
Article
em En, Es
| MEDLINE
| ID: mdl-29983197
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
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Síndrome do Desconforto Respiratório
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Oxigenação por Membrana Extracorpórea
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Desmame do Respirador
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Posicionamento do Paciente
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
/
Es
Ano de publicação:
2019
Tipo de documento:
Article