Investigation of the effectiveness of prone ventilation in patients followed up for acute respiratory distress syndrome in the intensive care unit

İ. Yıldırım, C. Aydın, A. Gültekin, M.T. İnal, D. Memiş

Department of Anesthesia and Reanimation, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey. drcihanaydin@hotmail.com

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• Anesthesiology

OBJECTIVE: Prone positioning has been found to improve oxygenation in most patients with acute respiratory distress syndrome (ARDS). The study aimed to investigate the effectiveness of the prone position in patients with ARDS.

PATIENTS AND METHODS: The prone position is one of the ventilator techniques included in recent guidelines for acute respiratory distress syndrome. This study was a retrospective evaluation of the records of 100 ARDS patients who were administered prone position mechanical ventilation in our intensive care unit. All patients were placed in the prone position for a total of 12 hours per day at 4-hour intervals (supine-prone) while admitted to the intensive care unit.

RESULTS: This study included 100 participants. These patients were divided into two groups as survivors [(n=38, 16 females, 22 males, median age: 60 (24-86)] and non-survivors [(n=62, 19 females, 43 males, median age: 64 (21-93)], according to their intensive care follow-ups. Acute physiology and chronic health evaluation (APACHE) II score, the sequential organ failure assessment score (SOFA), and inflammation markers were statistically significantly higher in the non-survivor group. Between the two groups, there was no statistically significant difference in terms of fundamental characteristics. In the sub-group evaluation of the subjects in patients with ARDS with and without novel coronavirus disease 2019 (COVID-19) groups, the patients in the COVID-19 (+) group were older, had shorter hospital stays, had higher APACHE II and SOFA scores, and higher rates of cardiovascular disease and sepsis.

CONCLUSIONS: Applying prone-position mechanical ventilation in the cohorts of our patients with ARDS resulted in a demonstrable significant improvement in the oxygenation levels of our patients.

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