Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/70471
標題: Effects of prone position on inflammatory markers in patients with ARDS due to community-acquired pneumonia
作者: Chan, M.C.
Hsu, J.Y.
Liu, H.H.
Lee, Y.L.
Pong, S.C.
Chang, L.Y.
Kuo, B.I.T.
Wu, C.L.
關鍵字: adult respiratory distress syndrome
ARDS
CAP
community-acquired
pneumonia
continuous prone position ventilation
respiratory-distress-syndrome
acute lung injury
randomized
controlled-trial
end-expiratory pressure
mechanical ventilation
severity
failure
model
期刊/報告no:: Journal of the Formosan Medical Association, Volume 106, Issue 9, Page(s) 708-716.
摘要: Background/Purpose: Acute respiratory distress syndrome (ARDS) is a serious disorder of intensive care unit patients. We evaluated the safety of continuous prone position ventilation (PRONE) and its effects on oxygenation and plasma cytokine concentrations in patients with ARDS caused by severe community-acquired pneumonia (CAP). Methods: This was a prospective observational clinical study conducted in a respiratory intensive care unit of a 1200-bed medical center in central Taiwan. Twenty-two patients with severe CAP and ARDS were included. They were treated by traditional supine ventilation (SUPINE, n = 11) or PRONE (n = 11) if they met the criteria for ARDS. Patients in the PRONE group were ventilated in prone position continuously for at least 72 hours. Plasma cytokines were collected and analyzed at baseline, 24 hours and 72 hours after enrolment. Serial PaO2/FiO(2) and complications were evaluated. Results: Complications associated with PRONE were minor and self-limited. PRONE had higher PaO2/FiO(2) ratio than SUPINE did at 48 hours after enrolment. The levels of plasma IL-6 concentration declined significantly with time in the PRONE group (p = 0.011). The levels of plasma IL-6 concentration at enrolment, 24 hours and 72 hours after enrolment also predicted the 14(th) day mortality of all patients. Conclusion: PRONE was a safe and effective maneuver for improving oxygenation in patients with severe CAP and ARDS. PRONE also influenced IL-6 expression in patients with severe CAP.
URI: http://hdl.handle.net/11455/70471
ISSN: 0929-6646
文章連結: http://dx.doi.org/10.1016/s0929-6646(08)60032-7
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