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| Effects of Different Prone Position Combined with Reverse Trendelenburg Position on Pulmonary Ventilation Function and Respiratory Mechanics in Acute Respiratory Distress Syndrome Patients |
| QI Yan-li, ZHANG Li |
| Department of Respiratory and Critical Care Medicine,Shangluo Central Hospital,Shangluo Shaanxi 726000 |
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Abstract 【Objective】To observe the effects of different prone positions combined with reverse Trendelenburg position on pulmonary ventilation function and respiratory mechanics in acute respiratory distress syndrome (ARDS) patients. 【Methods】A total of 96 patients with acute respiratory distress syndrome who underwent mechanical ventilation in Shangluo Central Hospital from February 2018 to March 2020 were enrolled in the study. Patients were divided into four groups by random digital table method. The A group was ventilated by routine prone position for 2 hours followed by reverse Trendelenburg supine position ventilation for another 2 hours; The B group received prone position ventilation for 2 hours,then prone position combined with reverse Trendelenburg supine position for 2 hours; The C group was ventilated by conventional prone position ventilation combined with reverse Trendelenburg supine position for 2 hours,follow by prone ventilation alone for 2 h. The pulmonary ventilation function,static compliance of the total respiratory system (Ctot) and static compliance of the chest wall (Ccw) of the three groups were compared. 【Results】Before the intervention,there was no significant difference in PaO2/FiO2 and PaCO2 among the three groups (P>0.05). After 2 hours of intervention,PaO2/FiO2 in group C was higher than that in group A (P<0.05),and PaCO2 in group C was lower than that in group A and group B (P<0.05). After 4 h of intervention,PaO2/FiO2 among three groups were statistically different (P<0.05),however,PaCO2 was no statistically significant among the three groups (P>0.05). There were no significant differences in both Ctot and Ccw among the three groups before intervention (P>0.05). After 2 hours of intervention,the Ccw of group C was higher than that of group A and B (P<0.05); After 4 hours of intervention,the Ccw of group C was significantly higher than that of group A and B(P<0.05). 【Conclusion】Combined prone position with reverse Trendelenburg supine position can shorten the PaO2/FiO2 recovery time and increase Ccw. In the nursing process,the patients' airway and respiratory management needs should be considered comprehensively,therefore a reasonable posture should be selected.
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Received: 29 December 2021
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2023, Vol. 40 
