Effects of Thoraco-Pelvic Supports in Prone Positioning for Lung Injury
Author Information
Author(s): Chiumello Davide, Cressoni Massimo, Racagni Milena, Landi Laura, Li Bassi Gianluigi, Polli Federico, Carlesso Eleonora, Gattinoni Luciano
Primary Institution: Fondazione IRCCS – 'Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena'
Hypothesis
Does the use of thoraco-pelvic supports during prone positioning improve gas exchange, hemodynamics, and respiratory mechanics in patients with acute lung injury/acute respiratory distress syndrome?
Conclusion
Thoraco-pelvic supports decrease chest wall compliance and increase pleural pressure without improving gas exchange, leading to their discontinuation in clinical practice.
Supporting Evidence
- The use of thoraco-pelvic supports led to a significant decrease in chest wall compliance.
- Heart rate increased significantly with the use of thoraco-pelvic supports.
- No significant differences in gas exchange variables were observed with or without supports.
Takeaway
This study looked at whether special supports help patients with lung problems when they lie on their stomach. It found that these supports don't help and can actually make things worse.
Methodology
The study involved 11 patients with ALI/ARDS who were mechanically ventilated and studied in both prone positions with and without thoraco-pelvic supports for 1 hour each.
Potential Biases
Potential for pressure sores due to increased contact pressures with supports.
Limitations
The study was short-term and did not investigate long-term effects of increased contact pressures.
Participant Demographics
11 intubated patients with ALI/ARDS, no history of chronic obstructive pulmonary disease, heart failure, or severe head trauma.
Statistical Information
P-Value
p = 0.0003 (heart rate), p = 0.0241 (stroke volume index)
Statistical Significance
p ≤ 0.05
Digital Object Identifier (DOI)
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