Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2022; 10(17): 5577-5585
Published online Jun 16, 2022. doi: 10.12998/wjcc.v10.i17.5577
Clinical evaluation of prone position ventilation in the treatment of acute respiratory distress syndrome induced by sepsis
Wen-Han Xia, Chun-Li Yang, Zhi Chen, Cheng-Hong Ouyang, Guo-Quan Ouyang, Qiu-Gen Li
Wen-Han Xia, Chun-Li Yang, Cheng-Hong Ouyang, Department of Intensive Care Unit, Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, Nanchang 330006, Jiangxi Province, China
Zhi Chen, Department of Emergency, Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, Nanchang 330006, Jiangxi Province, China
Guo-Quan Ouyang, Qiu-Gen Li, Department of Respiratory Medicine, Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, Nanchang 330006, Jiangxi Province, China
Author contributions: Xia WH and Li QG designed this retrospective study, Xia WH and Yang CL wrote the manuscript; Xia WH, Yang CL, Chen Z, Ouyang CH and Ouyang GQ were responsible for sorting the data.
Supported by Science and Technology Plan of Jiangxi Provincial Health Commission, No. 202130095.
Institutional review board statement: The study was reviewed and approved by the ethics committee of Jiangxi Provincial People’s Hospital Affiliated to Nanchang University Institutional Review Board (Approval No. 2016ED13).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiu-Gen Li, MM, Chief Physician, Department of Respiratory Medicine, Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, No. 92 Aiguo Road, Nanchang 330006, Jiangxi Province, China. liqiugen1976@163.com
Received: January 10, 2022
Peer-review started: January 10, 2022
First decision: February 14, 2022
Revised: February 26, 2022
Accepted: April 3, 2022
Article in press: April 3, 2022
Published online: June 16, 2022
Processing time: 149 Days and 23.3 Hours
ARTICLE HIGHLIGHTS
Research background

Previous studies have shown prone position ventilation (PPV) to be associated with improvement in oxygenation. However, its role in patients with acute respiratory distress syndrome (ARDS) caused by sepsis remains unknown.

Research motivation

This study analyzed the clinical effects of PPV in patients with ARDS caused by sepsis.

Research objectives

The study aimed to investigate whether PPV treatment can significantly improve patients’ heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), left ventricular ejection fraction (LVEF), mechanical ventilation time and intensive care unit (ICU)stay. And reduced post-ventilation C-reactive protein (CRP), procalcitonin (PCT) and interleukin-6 (IL-6) Levels and mortality.

Research methods

All enrolled patients received a lung-protective ventilation treatment strategy. The patients were divided into a control group (n = 55) (undergoing routine treatment) and prone position ventilation treatment group (n = 47) based on their positions during mechanical ventilation. Patients in the control group were treated with mechanical ventilation in the supine position combined with the lung-protective ventilation strategy while patients in the prone position ventilation treatment group were treated with prone position ventilation combined with the lung-protective ventilation strategy. HR, MAP, and CVP measurements were required for hemodynamic monitoring of arterial and central venous catheterization. The length of mechanical ventilation time and ICU stay, and levels of CRP, PCT, and IL-6 after ventilation. Finally, mortality rate was also compared between the two groups.

Research results

On the first day after ventilation, the oxygenation index and Cst were higher and Pplat level was lower in the PPV group than in the conventional treatment group. There were no significant differences in oxygenation index, Cst, and Pplat levels between the two groups on the 2nd, 4th, and 7th day after ventilation. There were no significant differences in HR, MAP, CVP, LVEF, duration of mechanical ventilation and ICU stay, and the levels of CRP, PCT, and IL-6 between the two groups on the first day after ventilation. There were significant differences on days 28 and 90 mortality in the PPV and control groups.

Research conclusions

Finally, PPV was not shown to cause any adverse effects on hemodynamics and inflammation indices.

Research perspectives

We will continue to investigate the improvement effect of prone position ventilation on other pulmonary function diseases.