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Critical Care
Published in: Critical Care 3/2005

Open Access 01-06-2005 | Research

Influence of support on intra-abdominal pressure, hepatic kinetics of indocyanine green and extravascular lung water during prone positioning in patients with ARDS: a randomized crossover study

Authors: Pierre Michelet, Antoine Roch, Marc Gainnier, Jean-Marie Sainty, Jean-Pierre Auffray, Laurent Papazian

Published in: Critical Care | Issue 3/2005

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Abstract

Introduction

Prone positioning (PP) on an air-cushioned mattress is associated with a limited increase in intra-abdominal pressure (IAP) and an absence of organ dysfunction. The respective influence of posture by itself and the type of mattress on these limited modifications during the PP procedure remains unclear. The aim of this study was to evaluate whether the type of support modifies IAP, extravascular lung water (EVLW) and the plasma disappearance rate of indocyanine green (PDRICG) during PP.

Methods

A prospective, randomized, crossover study of 20 patients with acute respiratory distress syndrome (ARDS) was conducted in a medical intensive care unit in a teaching hospital. Measurements were made at baseline and repeated after 1 and 6 hours of two randomized periods of 6 hours of PP with one of two support types: conventional foam mattress or air-cushioned mattress.

Results

After logarithmic transformation of the data, an analysis of variance (ANOVA) showed that IAP and PDRICG were significantly influenced by the type of support during PP with an increase in IAP (P < 0.05 by ANOVA) and a decrease in PDRICG on the foam mattress (P < 0.05 by ANOVA). Conversely, the measurements of EVLW did not show significant modification between the two supports whatever the posture. The ratio of the arterial oxygen tension to the fraction of inspired oxygen significantly increased in PP (P < 0.0001 by ANOVA) without any influence of the support.

Conclusion

In comparison with a conventional foam mattress, the use of an air-cushioned mattress limited the increase in IAP and prevented the decrease in PDRICG related to PP in patients with ARDS. Conversely, the type of support did not influence EVLW or oxygenation.
Appendix
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Metadata
Title
Influence of support on intra-abdominal pressure, hepatic kinetics of indocyanine green and extravascular lung water during prone positioning in patients with ARDS: a randomized crossover study
Authors
Pierre Michelet
Antoine Roch
Marc Gainnier
Jean-Marie Sainty
Jean-Pierre Auffray
Laurent Papazian
Publication date
01-06-2005
Publisher
BioMed Central
Published in
Critical Care / Issue 3/2005
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc3513

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