Prone position in mechanically ventilated patients with reduced intracranial compliance
- 10 July 2006
- journal article
- Published by Wiley in Acta Anaesthesiologica Scandinavica
- Vol. 50 (8), 937-941
- https://doi.org/10.1111/j.1399-6576.2006.01037.x
Abstract
Prone position has been used for several years to treat acute lung insufficiency, but in previous studies patients with unstable intracranial pressure (ICP) are mostly excluded. The aim of this study was to investigate if prone position is a safe and useful treatment in patients with reduced intracranial compliance.A consecutive, prospective pilot study of 11 patients admitted to the neuro intensive care unit (NICU) due to traumatic brain injury or intracerebral haemorrhage. ICP, cerebral perfusion pressure (CPP), heart rate (HR), mean arterial blood pressure (MABP), arterial partial pressure of oxygen (PaO(2)), arterial partial pressure of carbon dioxide (PaCO(2)), arterial oxygen saturation (SaO(2)) and respiratory system compliance were measured before, three times during and two times after the patients were placed in the prone position.No significant changes were demonstrated in ICP, CPP or MABP. PaO(2) and SaO(2) were significantly increased in the prone position. HR was significantly increased in the prone position and after 10 min in the supine post-prone position and the respiratory system compliance was increased after 1 h in the supine post-prone position.Turning NICU patients from the supine to the prone position did not influence ICP, CPP or MABP, but significantly improved patient PaO(2), SaO(2) and respiratory system compliance.Keywords
This publication has 14 references indexed in Scilit:
- Effects of Head Posture on Cerebral Hemodynamics: Its Influences on Intracranial Pressure, Cerebral Perfusion Pressure, and Cerebral OxygenationNeurosurgery, 2004
- Anatomic Evaluation of Postural Bronchial Drainage of the Lung With Special Reference to Patients With Tracheal IntubationSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2004
- Prone position in subarachnoid hemorrhage patients with acute respiratory distress syndrome: Effects on cerebral tissue oxygenation and intracranial pressure*Critical Care Medicine, 2003
- Use of prone ventilation in neurogenic pulmonary oedemaBritish Journal of Anaesthesia, 2003
- Surveillance of nosocomial infections in a neurology intensive care unitZeitschrift für Neurologie, 2001
- Intensive care management of head-injured patients in Europe: a survey from the European Brain Injury ConsortiumIntensive Care Medicine, 2001
- Prone positioning for acute respiratory distress syndrome in the surgical intensive care unit: Who, when, and how long?Surgery, 2000
- Analysis of Risk Factors for Ventilator-Associated Pneumonia in a Multidisciplinary Intensive Care UnitEuropean Journal of Clinical Microbiology & Infectious Diseases, 2000
- Intracranial hypertension in head injury: management and resultsIntensive Care Medicine, 1999
- Correlation of gas exchange impairment to development of atelectasis during anaesthesia and muscle paralysisActa Anaesthesiologica Scandinavica, 1986