| Title |
Prolonged prone positioning under VV-ECMO is safe and improves oxygenation and respiratory compliance
|
|---|---|
| Published in |
Annals of Intensive Care, November 2015
|
| DOI | 10.1186/s13613-015-0078-4 |
| Pubmed ID | |
| Authors |
Antoine Kimmoun, Sylvain Roche, Céline Bridey, Fabrice Vanhuyse, Renaud Fay, Nicolas Girerd, Damien Mandry, Bruno Levy |
| Abstract |
Data are sparse regarding the effects of prolonged prone positioning (PP) during VV-ECMO. Previous studies, using short sessions (<12 h), failed to find any effects on respiratory system compliance. In the present analysis, the effects of prolonged PP sessions (24 h) were retrospectively studied with regard to safety data, oxygenation and respiratory system compliance. Retrospective review of 17 consecutive patients who required both VV-ECMO and prone positioning. PP under VV-ECMO was considered when the patient presented at least one unsuccessful ECMO weaning attempt after day 7 or refractory hypoxemia combined or not with persistent high plateau pressure. PP sessions had a duration of 24 h with fixed ECMO and respiratory settings. PP was not performed in patients under vasopressor treatment and in cases of recent open chest cardiac surgery. Despite optimized protective mechanical ventilation and other adjuvant treatment (i.e. PP, inhaled nitric oxide, recruitment maneuvers), 44 patients received VV-ECMO during the study period for refractory acute respiratory distress syndrome. Global survival rate was 66 %. Among the latter, 17 patients underwent PP during VV-ECMO for a total of 27 sessions. After 24 h in prone position, PaO2/FiO2 ratio significantly increased from 111 (84-128) to 173 (120-203) mmHg (p < 0.0001) while respiratory system compliance increased from 18 (12-36) to 32 (15-36) ml/cmH2O (p < 0.0001). Twenty-four hours after the return to supine position, tidal volume was increased from 3.0 (2.2-4.0) to 3.7 (2.8-5.0) ml/kg (p < 0.005). PaO2/FiO2 ratio increased by over 20 % in 14/14 sessions for late sessions (≥7 days) and in 7/13 sessions for early sessions (<7 days) (p = 0.01). Quantitative CT scan revealed a high percentage of non-aerated or poorly-aerated lung parenchyma [52 % (41-62)] in all patients. No correlation was found between CT scan data and respiratory parameter changes. Hemodynamics did not vary and side effects were rare (one membrane thrombosis and one drop in ECMO blood flow). When used in combination with VV-ECMO, 24 h of prone positioning improves both oxygenation and respiratory system compliance. Moreover, our study confirms the absence of serious adverse events. |
X Demographics
The data shown below were collected from the profiles of 16 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 5 | 31% |
| Norway | 2 | 13% |
| Vietnam | 1 | 6% |
| France | 1 | 6% |
| Venezuela, Bolivarian Republic of | 1 | 6% |
| Australia | 1 | 6% |
| Thailand | 1 | 6% |
| Canada | 1 | 6% |
| Italy | 1 | 6% |
| Other | 1 | 6% |
| Unknown | 1 | 6% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 38% |
| Practitioners (doctors, other healthcare professionals) | 6 | 38% |
| Science communicators (journalists, bloggers, editors) | 2 | 13% |
| Scientists | 2 | 13% |
Mendeley readers
The data shown below were compiled from readership statistics for 109 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 109 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 15 | 14% |
| Researcher | 11 | 10% |
| Student > Master | 11 | 10% |
| Student > Ph. D. Student | 8 | 7% |
| Student > Postgraduate | 8 | 7% |
| Other | 27 | 25% |
| Unknown | 29 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 56 | 51% |
| Nursing and Health Professions | 6 | 6% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 2% |
| Unspecified | 2 | 2% |
| Biochemistry, Genetics and Molecular Biology | 2 | 2% |
| Other | 7 | 6% |
| Unknown | 34 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 September 2020.
All research outputs
#3,346,297
of 23,613,071 outputs
Outputs from Annals of Intensive Care
#420
of 1,074 outputs
Outputs of similar age
#48,635
of 286,576 outputs
Outputs of similar age from Annals of Intensive Care
#6
of 24 outputs
Altmetric has tracked 23,613,071 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,074 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.2. This one has gotten more attention than average, scoring higher than 60% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 286,576 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 82% of its contemporaries.
We're also able to compare this research output to 24 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 79% of its contemporaries.