Prone positioning before extracorporeal membrane oxygenation for severe acute respiratory distress syndrome: A retrospective multicenter study
- Authors
- Kim, W. -Y.; Kang, B. J.; Chung, C. R.; Park, S. H.; Oh, J. Y.; Park, S. Y.; Cho, W. H.; Sim, Y. S.; Choi, Y. -J.; Park, S.; Kim, J. -H.; Hong, S. -B.
- Issue Date
- Oct-2019
- Publisher
- ELSEVIER ESPANA SLU
- Keywords
- Prone position; Extracorporeal membrane oxygenation; Respiratory distress syndrome, adult; Respiration, artificial
- Citation
- MEDICINA INTENSIVA, v.43, no.7, pp 402 - 409
- Pages
- 8
- Journal Title
- MEDICINA INTENSIVA
- Volume
- 43
- Number
- 7
- Start Page
- 402
- End Page
- 409
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/69453
- DOI
- 10.1016/j.medin.2018.04.013
- ISSN
- 0210-5691
1578-6749
- Abstract
- Objective: To evaluate the clinical outcomes of patients with severe acute respiratory distress syndrome (ARDS) subjected to prone positioning before extracorporeal membrane oxygenation (ECMO). Design: A retrospective analysis of a multicenter cohort was carried out. Setting: Patients admitted to the Intensive Care Units of 11 hospitals in Korea. Patients: Patients were divided into those who underwent prone positioning before ECMO (n = 28) and those who did not (n = 34). Interventions: None. Variables of interest: Thirty-day mortality, ECMO weaning failure rate, mechanical ventilation weaning success rate, mechanical ventilation-free days at day 60. Results: The prone group had lower median peak inspiratory pressure and lower median dynamic driving pressure before ECMO. Thirty-day mortality was 21% in the prone group and 41% in the non-prone group (p = 0.098). The prone group also showed a lower ECMO weaning failure rate, and a higher mechanical ventilation weaning success rate and more mechanical ventilation-free days at day 60. In the non-prone group, median dynamic compliance marginally decreased shortly after ECMO, but no significant change was observed in the prone group. Conclusions: Prone positioning before ECMO was not associated to increased mortality and tended to exert a protective effect. (C) 2018 Elsevier Espana, S.L.U. y SEMICYUC. All rights reserved.
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