Objective To explore the effects of lateral position ventilation on lung volume and oxygenation in patients with acute respiratory distress syndrome ( ARDS) . Methods Fourteen patients with ARDS were enrolled. Supine position, lateral position and supine position were successively adopted and continued for one hour respectively. End-expiratory lung volume ( EELV) was measured at the end of each epoch. Effects of different position on gas exchange, lung mechanics and hemodynamics were monitored.Results EELV was increased from ( 1109 ±321) mL to ( 1376 ±381) mL after lateral ventilation ( P lt;0. 05) , and decreased to ( 1143 ±376) mL after the second supine ventilation ( P lt;0. 05) . Compared with initial supine ventilation, there was no significant difference in EELV after the second supine ventilation
( P gt;0. 05) . PaO2 /FiO2 was increased from ( 154. 3 ±35. 0) mm Hg to ( 189. 9 ±60. 1) mm Hg after lateral ventilation ( P lt;0. 05) , and increased to ( 209. 2 ±75. 4) mm Hg after the second supine ventilation ( P lt; 0. 05) . Compared with initial supine ventilation, PaO2 /FiO2 was increased greatly after the second
supine ventilation ( P lt; 0. 01) . There was no significant difference in PaCO2 , lung mechanics and hemodynamics after changing different position. Conclusion Lateral position ventilation can increase EELV and improve oxygenation in patients with ARDS.
Citation：
YU Xiangyou,PAN Pengfei,BaihetinishaTuerdi. Effects of Lateral Position Ventilation on Lung Volume and Oxygenation in Patients with Acute Respiratory Distress Syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(6): 555-557. doi:
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Copyright © the editorial department of Chinese Journal of Respiratory and Critical Care Medicine of West China Medical Publisher. All rights reserved
| 1. |
吴威士, 罗敏, 杨翠华. 急性肺损伤/急性呼吸窘迫综合征患者侧卧位通气与俯卧位通气的对比观察. 中华结核和呼吸杂志,2004, 27: 589-592.
|
| 2. |
Tongyoo S, Vilaichone W, Ratanarat R, et al. The effect of lateral position on oxygenation in ARDS patients: a pilot study. J Med Assoc Thai, 2006, 89( Suppl 5) : S55-S61.
|
| 3. |
张丽娜, 艾宇航. 急性呼吸窘迫综合征患者侧卧位通气与俯卧位通气的临床疗效观察. 中国急救医学, 2006, 26: 908-910.
|
| 4. |
中华医学会呼吸病学分会. 急性肺损伤/急性呼吸窘迫综合征的诊断标准( 草案) . 中华结核和呼吸杂志, 2000, 23: 203.
|
| 5. |
中华医学会重症医学分会. 急性肺损伤/急性呼吸窘迫综合征诊断和治疗指南( 2006) . 中国危重病急救医学, 2006,18:706-710.
|
| 6. |
Remolina C, Khan AU, Santiago TV, et al. Positional hypoxemia in unilateral lung disease. N Engl JMed, 1981, 304: 523-525.
|
| 7. |
Flaatten H, Aardal S, Hevr y O. Improved oxygenation using the prone position in patients with ARDS. Acta Anaesthesiol Scand,1998, 42: 329-334.
|
| 8. |
Staudinger T, Kofler J, 秦龙, 等. 成人呼吸窘迫综合征病人俯卧位和持续变换体位通气的比较: 一项初步研究. 世界医学杂志,2002, 6: 9-13.
|
| 9. |
Klingstedt C, Hedenstiema G, Baehrendtz S, et al. Ventilationperfusion relationships and atelectasis formation in the supine and lateral positions during conventional mechanical and differential ventilation. Acta Anaesthesiol Scand, 1990 , 34: 421 -429.
|
| 10. |
Oleg rd C, S ndergaard S, Houltz E, et al. Estimation of functional residual capacity at the bedside using standard monitoring equipment: a modified nitrogen washout/ washin technique requiring a small change of the inspired oxygen fraction. Anesth Analg, 2005 ,101: 206-212.
|
| 11. |
Heinze H, Sedemund-Adib B, Heringlake M, et al. Functional residual capacity changes after different endotracheal suctioning methods. Anesth Analg, 2008, 107: 941-944.
|
- 1. 吴威士, 罗敏, 杨翠华. 急性肺损伤/急性呼吸窘迫综合征患者侧卧位通气与俯卧位通气的对比观察. 中华结核和呼吸杂志,2004, 27: 589-592.
- 2. Tongyoo S, Vilaichone W, Ratanarat R, et al. The effect of lateral position on oxygenation in ARDS patients: a pilot study. J Med Assoc Thai, 2006, 89( Suppl 5) : S55-S61.
- 3. 张丽娜, 艾宇航. 急性呼吸窘迫综合征患者侧卧位通气与俯卧位通气的临床疗效观察. 中国急救医学, 2006, 26: 908-910.
- 4. 中华医学会呼吸病学分会. 急性肺损伤/急性呼吸窘迫综合征的诊断标准( 草案) . 中华结核和呼吸杂志, 2000, 23: 203.
- 5. 中华医学会重症医学分会. 急性肺损伤/急性呼吸窘迫综合征诊断和治疗指南( 2006) . 中国危重病急救医学, 2006,18:706-710.
- 6. Remolina C, Khan AU, Santiago TV, et al. Positional hypoxemia in unilateral lung disease. N Engl JMed, 1981, 304: 523-525.
- 7. Flaatten H, Aardal S, Hevr y O. Improved oxygenation using the prone position in patients with ARDS. Acta Anaesthesiol Scand,1998, 42: 329-334.
- 8. Staudinger T, Kofler J, 秦龙, 等. 成人呼吸窘迫综合征病人俯卧位和持续变换体位通气的比较: 一项初步研究. 世界医学杂志,2002, 6: 9-13.
- 9. Klingstedt C, Hedenstiema G, Baehrendtz S, et al. Ventilationperfusion relationships and atelectasis formation in the supine and lateral positions during conventional mechanical and differential ventilation. Acta Anaesthesiol Scand, 1990 , 34: 421 -429.
- 10. Oleg rd C, S ndergaard S, Houltz E, et al. Estimation of functional residual capacity at the bedside using standard monitoring equipment: a modified nitrogen washout/ washin technique requiring a small change of the inspired oxygen fraction. Anesth Analg, 2005 ,101: 206-212.
- 11. Heinze H, Sedemund-Adib B, Heringlake M, et al. Functional residual capacity changes after different endotracheal suctioning methods. Anesth Analg, 2008, 107: 941-944.
