Prone positioning, systemic hemodynamics, hepatic indocyanine green kinetics, and gastric intramucosal energy balance in patients with acute lung injury
Intensive Care MedicinePublished 4 December 2001Open access
Rudolf Hering, Ralph Vorwerk, Hermann Wrigge, Jörg Zinserling, Stefan Schröder, Tilman von Spiegel
Citations95
SJR quartileQ1
SJR score5.00
SNIP6.11
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Prone positioning in mechanically ventilated patients with acute lung injury, despite a small increase in IAP, does not negatively affect the hepatic capacity to eliminate ICG and gastric intramucosal energy balance when systemic blood flow and oxygenation are improved.
Abstract
Prone positioning in mechanically ventilated patients with acute lung injury, despite a small increase in IAP, does not negatively affect the hepatic capacity to eliminate ICG and gastric intramucosal energy balance when systemic blood flow and oxygenation are improved.
Keywords
Medicine
American Journal of Respiratory and Critical Care MedicineThe American-European Consensus Conference On Ards. Definitions, Mechanisms, Relevant Outcomes, And Clinical Trial Coordination
6,782 Citations1994Gordon R. Bernard, Antonio Artigas +8 more
The acute respiratory distress syndrome (ARDS), a process of nonhydrostatic pulmonary edema and hypoxemia associated with a variety of etiologies, carries a high morbidity, mortality, and financial cost.
BMJControlled Sedation with Alphaxalone-Alphadolone
2,913 Citations1974Michael A. E. Ramsay, T.M. Savege +2 more
Alphaxalone-alphadolone (Althesin), diluted and administered as a controlled infusion, was used as a sedative for 30 patients in an intensive therapy unit and provided “light sleep,” allowed rapid variation in the level of sedation, and enabled repeated assessment of the central nervous system.
Archives of SurgeryMultiple-Organ Failure
1,303 Citations1985R. Jan A. Goris
It is concluded that sepsis is probably not the essential cause of MOF, and an alternative hypothesis is presented involving massive activation of inflammatory mediators by severe tissue trauma or intra-abdominal sepsi, resulting in systemic damage to vascular endothelia, permeability edema, and impaired oxygen availability to the mitochondria despite adequate arterial oxygen transport.
Critical Care MedicineA simplified acute physiology score for ICU patients
1,271 Citations1984Jean‐Roger Le Gall, P. Loirat +7 more
The simplified acute physiology score (SAPS), evaluated in 679 consecutive patients admitted to eight multidisciplinary referral ICUs in Francece, was a simpler and less time-consuming method for comparative studies and management evaluation between different ICUs.
American Journal of Respiratory and Critical Care MedicineAcute Respiratory Distress Syndrome Caused by Pulmonary and Extrapulmonary Disease: Different Syndromes?
899 Citations1998Luciano Gattinoni, Paolo Pelosi +4 more
The different respiratory mechanics and response to PEEP observed are consistent with a prevalence of consolidation in ARDSp as opposed to prevalent edema and alveolar collapse in ARDSexp.
Intensive Care MedicineReport of the American-European consensus conference on ARDS: Definitions, mechanisms, relevant outcomes and clinical trial coordination
697 Citations1994Gordon R. Bernard, Antonio Artigas +8 more
It was felt that international coordination between North America and Europe in clinical studies of ARDS was becoming increasingly important in order to address the recent plethora of potential therapeutic agents for the prevention and treatment of AR DS.
American Journal of Respiratory and Critical Care MedicineEffects of the Prone Position on Respiratory Mechanics and Gas Exchange during Acute Lung Injury
511 Citations1998Paolo Pelosi, Daniela Tubiolo +5 more
B baseline Cst,w and its changes may play a role in determining the oxygenation response in the prone position; (2) theprone position improves CSt,rs and CST,L when the supine position is resumed.
The Journal of Trauma: Injury, Infection, and Critical CareEFFECT OF INCREASED INTRA-ABDOMINAL PRESSURE ON HEPATIC ARTERIAL, PORTAL VENOUS, AND HEPATIC MICROCIRCULATORY BLOOD FLOW
406 Citations1992Lawrence N. Diebel, Robert F. Wilson +2 more
American Journal of Respiratory and Critical Care MedicineProne Position in Mechanically Ventilated Patients With Severe Acute Respiratory Failure
367 Citations1997G. Chatté, J. M. Sab +4 more
Patients with severe acute respiratory failure, unrelated to left ventricular failure to atelectasis, were turned to and from a supine to prone position at 1- and 4-h intervals to characterize changes in oxygenation.
CHEST JournalInfluence of Positioning on Ventilation-Perfusion Relationships in Severe Adult Respiratory Distress Syndrome
353 Citations1994D. Pappert, Rolf Rossaint +3 more
It is concluded that improvement of oxygenation during pressure-controlled mechanical ventilation in the prone position is due to a shift of blood flow away from shunt regions, thus increasing areas with normal VA/Q.
World Journal of SurgeryGut Ischemia, Oxidative Stress, and Bacterial Translocation in Elevated Abdominal Pressure in Rats
278 Citations1996E. Eleftheriadis, Katerina Kotzampassi +3 more
It is concluded that elevated intraabdominal pressure in the rat leads to intestinal ischemia, oxygen free radical production, and bacterial translocation.
Intensive Care MedicineMorphological response to positive end expiratory pressure in acute respiratory failure. Computerized tomography study
253 Citations1986Luciano Gattinoni, D. Mascheroni +10 more
The ARF lungs appeared as a patchwork of normal and dense areas with generally well defined boundaries, but the modifications of gas exchange can not be entirely predicted from morphological changes, possibly due to a diversion of pulmonary blood flow.
AnesthesiologyDetermination of Intra-abdominal Pressure Using a Transurethral Bladder Catheter
211 Citations1989Thomas J. Iberti, Charles E. Lieber +1 more
The authors conclude that transurethral monitoring of bladder pressure offers a safe, simple, and highly accurate method for evaluating IAP at the bedside, and studies evaluating the indication for its use in the operating room and intensive care settings appear warranted.
Intensive Care MedicineShort-term effects of prone position in critically ill patients with acute respiratory distress syndrome
198 Citations1997Lluís Blanch, Jordi Mancebo +8 more
The data suggest that prone positioning should be carried out early in the course of ARDS, and that turning critically ill, severely hypoxemic patients from the supine to the prone position is a safe and useful therapeutic intervention.
Critical Care MedicineEffects of the prone position on gas exchange and hemodynamics in severe acute respiratory distress syndrome
181 Citations1998Philippe Jolliet, Pierre Bulpa +1 more
The prone position can improve oxygenation in severely hypoxemic ARDS patients without deleterious effects on hemodynamics and Repeated daily trials in the prone position should be considered in the management of AR DS patients with severe hypoxemia.
Journal of Critical CareTissue-arterial PC02 difference is a better marker of ischemia than intramural pH (pHi) or arterial pH-pHi difference
170 Citations1996Robert Schlichtig, Navdeep Mehta +1 more
P(t-a)CO2 is a more reliable index of gastric oxygenation than is pHi alone or pH(ap-i, however, it was further shown that pH(AP-i) can be associated with a wide range of P( t-a-CO2, depending on the magnitude of pH( ap-i), and on the PaCO2 at which P(t)-a) CO2 is measured.
Anesthesia & AnalgesiaThe Effects of Prone Positioning on Intraabdominal Pressure and Cardiovascular and Renal Function in Patients with Acute Lung Injury
168 Citations2001Rudolf Hering, Hermann Wrigge +7 more
P prone positioning, when used in patients with acute lung injury, although it is associated with a small increase in IAP, contributes to improved arterial oxygenation and systemic blood flow without affecting renal perfusion and function.
CHEST JournalClinical Outcome of Respiratory Failure in Patients Requiring Prolonged (>24 Hours) Mechanical Ventilation
146 Citations1986Delmar J. Gillespie, Herbert W. Marsh +2 more
Patients requiring prolonged (>24 hours) mechanical ventilation have various conditions that result in respiratory failure, and acute lung injury and chronic obstructive pulmonary disease were the predominant conditions.
Cardiovascular ResearchEstimation of splanchnic blood flow by the Fick principle in man and problems in the use of indocyanine green
123 Citations1995Ari Uusaro
Journal of Clinical AnesthesiaHemodynamic evaluation of the prone position by transesophageal echocardiography
111 Citations1998Shigeyoshi Toyota, Yoshikiyo Amaki
The prone position caused LVV to decrease, and this change was probably due to a decrease in the venous return due to inferior vena caval compression, and decreased left ventricular compliance due to increased intrathoracic pressure in the prone position.
Intensive Care MedicineAerosolized prostacyclin and inhaled nitric oxide in septic shock — different effects on splanchnic oxygenation?
70 Citations1996Otto Eichelbrönner, Helmut Reinelt +5 more
The data suggest that aerosolized prostacy Clin — unlike nitric oxide — has similar beneficial effects on splanchnic perfusion and oxygenation as intravenous prostacyclin without detrimental effects on systemic hemodynamics.
Cardiovascular ResearchEstimation of splanchnic blood flow by the Fick principle in man and problems in the use of indocyanine green
70 Citations1995Ari Uusaro, Esko Ruokonen +1 more
The prerequisites for the method of primed, constant infusion of indocyanine green with hepatic vein catheterization are achieved in intensive care patients and the results of splanchnic blood flow estimations based on techniques with peripheral blood sampling should be interpreted with caution.
Canadian Journal of Anesthesia/Journal canadien d anesthésieTransoesophageal echocardiography during scoliosis repair: comparison with CVP monitoring
67 Citations1998Daniel Soliman, Andrew Maslow +5 more
These data indicate that the CVP is a misleading monitor of cardiac volume in patients with kyphosis/scoliosis in the prone position and transoesophageal echocardiography may be a more useful monitoring tool to assess on-line ventricular size and function.
American Journal of Respiratory and Critical Care MedicineEffects of Dobutamine on Gastric Mucosal Perfusion and Hepatic Metabolism in Patients with Septic Shock
66 Citations1999Luc‐Marie Joly, Mehran Monchi +5 more
Dobutamine increases gastric mucosal perfusion but does not alter hepatocytic clearance in patients with septic shock, suggesting the absence of a beneficial effect of dobutamine on hepatocytics clearance may be related to profound alterations in hepatocellular metabolism during septicshock.
Yearbook of intensive care and emergency medicineTranspulmonary Indicator Dilution: An Alternative Approach for Hemodynamic Monitoring
37 Citations1995Andreas Hoeft
Hemodilution using a pulmonary artery catheter is still the “gold standard” and is routinely used in most institutions for assessment of cardiac output.
Intensive Care MedicineAdvantage of buffered solutions or automated capnometry in air-filled balloons for use in gastric tonometry
35 Citations1997Bettina Temmesfeld‐Wollbrück, ANTAL SZALAY +3 more
Air-filled balloons, combined with automated capnometry, present excellent accuracy and reproducibility together with short equilibration times, thus offering “on-line” monitoring of even rapid changes in environmental pCO2.
PubMed[Effect of the prone position on ICG excretion during normotensive or hypotensive isoflurane anesthesia].
2 Citations1993Junichiro Aono, Wataru Ueda +2 more
The results suggest that prone position decreases the hepatic blood flow or hepatic function during isoflurane anesthesia.