Effect of prone positioning on the survival of patients with acute respiratory failure

Article Abstract:

Placing hospital patients with acute respiratory failure on their stomach instead of their back can improve oxygen delivery to the lungs, but it does not reduce mortality rates. This was the conclusion of a study of 304 patients, half of whom laid on their stomach and half on their back.

Patients, Positioning (Patient care)

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Regional effects and mechanism of positive end-expiratory pressure in early adult respiratory distress syndrome

Article Abstract:

Positive end-expiratory pressure (PEEP) appears to prevent lungs from collapsing by counteracting hydrostatic pressure superimposed (SPL) on the lung in patients with early adult respiratory distress syndrome (ARDS). SPL is elevated in patients with ARDS because of increased tissue mass, and this is thought to cause compression of the lungs. Ten patients with ARDS with significantly elevated SPL were treated with increasing levels of PEEP and their response was measured through CT scanning. PEEP opened or maintained open areas of the lungs that otherwise would have collapsed from SPL. Areas that had collapsed remained inflated when PEEP equalled or exceeded SPL.

Evaluation, Prevention, Positive pressure respiration, Atelectasis

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A trial of goal-oriented hemodynamic therapy in critically ill patients

Article Abstract:

Raising the volume of blood pumped by the heart or the amount of oxygen delivered by the blood to above-normal levels may not improve the prognosis of patients in critical condition. A total of 762 patients in intensive care units received hemodynamic therapy involving increasing blood volume and administering drugs that effect the function of the heart and blood vessels. They were divided into three groups based on the goals of therapy: the control group of 252 patients was to have a normal volume pumped by the heart every minute; the cardiac-index group of 253 patients was to have an abnormally high volume of blood pumped by the heart; and the oxygen saturation group of 257 patients was to have an abnormally high level of oxygen in their arteries. The mortality in each group was approximately 50% at discharge from the intensive care unit and approximately 62% six months later. The number of organs that were not functioning during treatment were also similar in each group.

Management, Hemodynamics, Critically ill

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