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| Effects of Different Positions on Hemodynamics in Patients with Severe Pneumonias Undergoing Lung Recruitment Therapy |
| YAN Xi-xiang, ZHENG Ai-dong, ZHANG Zhen-en, et al |
| Jianhu County Hospital Affiliated to Nantong University,Yancheng Jiangsu 224700 |
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Abstract 【Objective】To investigate the effects of different positions on hemodynamics in patients with severe pneumonias undergoing lung recruitment therapy. 【Methods】Ninety patients with severe pneumonia were divided into supine position group (group A) and prone position group (group B ) according to the body position selected in the treatment of lung recruitment. The changes of oxygen metabolism were observed before, 5 minutes and 1 hour after pulmonary reopening, including arterial partial pressure of oxygen (PaO2), mixed venous partial pressure of oxygen (PvO2), central venous oxygen saturation (ScvO2), oxygen supply (DO2) and oxygen uptake rate (ERO2).Hemodynamic changes were recorded before, immediately after and 1 hour after pulmonary recruitment, including central venous pressure (CVP), cardiac index (CI), global ejection fraction (GEF), peripheral vascular resistance index (SVRI), stroke volume variation (SVV), intrathoracic blood volume index (ITBVI). The incidence of complications in the two groups was also observed. 【Results】The levels of PAO2, PvO2, ScvO2 and DO2 of the two groups before lung recruitment were higher than those at 5min and 1h after recruitment (P<0.05). Those parameters in group B were significantly higher than those in the group A (P<0.05). The level of ERO2 at 5 minutes and 1 hour after lung recruitment was lower than that before lung recruitment (P<0.05), however, there was no statistically significant difference in between (P>0.05).The CVP, CI and GEF levels of the two groups immediately after recruitment were significantly lower than those before lung recruitment (P<0.05), and the SVV was significantly higher than that before lung recruitment (P<0.05).There were no significant differences in CVP, CI, GEF, SVRI, SVV and ITBVI between the two groups (P>0.05).There was no significant difference in the incidence of subcutaneous emphysema, pneumothorax and barotrauma between the two groups as well (P>0.05). 【Conclusion】Choosing supine position or prone position for lung recruitment in patients with severe pneumonia has less influence on hemodynamics and fewer complications. Prone position can further improve oxygen metabolism, and the effect is more remarkable.
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Received: 19 September 2019
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2020, Vol. 37 
