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Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery

INTRODUCTION: In Acute Respiratory Distress Syndrome (ARDS), the heterogeneity of lung lesions results in a mis-match between ventilation and perfusion, leading to the development of hypoxia. The study aimed to examine the association between computed tomographic (CT scan) lung findings in patients...

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Autores principales: Akatsuka, Masayuki, Tatsumi, Hiroomi, Yama, Naoya, Masuda, Yoshiki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sciendo 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029406/
https://www.ncbi.nlm.nih.gov/pubmed/32104729
http://dx.doi.org/10.2478/jccm-2020-0003
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author Akatsuka, Masayuki
Tatsumi, Hiroomi
Yama, Naoya
Masuda, Yoshiki
author_facet Akatsuka, Masayuki
Tatsumi, Hiroomi
Yama, Naoya
Masuda, Yoshiki
author_sort Akatsuka, Masayuki
collection PubMed
description INTRODUCTION: In Acute Respiratory Distress Syndrome (ARDS), the heterogeneity of lung lesions results in a mis-match between ventilation and perfusion, leading to the development of hypoxia. The study aimed to examine the association between computed tomographic (CT scan) lung findings in patients with ARDS after abdominal surgery and improved hypoxia and mortality after prone ventilation. MATERIAL AND METHODS: A single site, retrospective observational study was performed at the Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan, between 1st January 2004 and 31st October 2018. Patients were allocated to one of two groups after CT scanning according to the presence of ground-glass opacity (GGO) or alveolar shadow with predominantly dorsal lung atelectasis (DLA) on lung CT scan images. Also, Patients were divided into a prone ventilation group and a supine ventilation group when the treatment for ARDS was started. RESULTS: We analyzed data for fifty-one patients with ARDS following abdominal surgery. CT scans confirmed GGO in five patients in the Group A and in nine patients in the Group B, and DLA in 17 patients in the Group A and nine patients in the Group B. Both GGO and DLA were present in two patients in the Group A and nine patients in the Group B. Prone ventilation significantly improved patients’ impaired ratio of arterial partial pressure of oxygen to fraction of inspired oxygen from 12 h after prone positioning compared with that in the supine position. Weaning from mechanical ventilation occurred significantly earlier in the Group A with DLA vs the Group B with DLA (P < 0.001). Twenty-eight-day mortality was significantly lower for the Group A with DLA vs the Group B with DLA (P = 0.035). CONCLUSIONS: These results suggest that prone ventilation could be effective for treating patients with ARDS as showing the DLA.
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spelling pubmed-70294062020-02-26 Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery Akatsuka, Masayuki Tatsumi, Hiroomi Yama, Naoya Masuda, Yoshiki J Crit Care Med (Targu Mures) Research Article INTRODUCTION: In Acute Respiratory Distress Syndrome (ARDS), the heterogeneity of lung lesions results in a mis-match between ventilation and perfusion, leading to the development of hypoxia. The study aimed to examine the association between computed tomographic (CT scan) lung findings in patients with ARDS after abdominal surgery and improved hypoxia and mortality after prone ventilation. MATERIAL AND METHODS: A single site, retrospective observational study was performed at the Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan, between 1st January 2004 and 31st October 2018. Patients were allocated to one of two groups after CT scanning according to the presence of ground-glass opacity (GGO) or alveolar shadow with predominantly dorsal lung atelectasis (DLA) on lung CT scan images. Also, Patients were divided into a prone ventilation group and a supine ventilation group when the treatment for ARDS was started. RESULTS: We analyzed data for fifty-one patients with ARDS following abdominal surgery. CT scans confirmed GGO in five patients in the Group A and in nine patients in the Group B, and DLA in 17 patients in the Group A and nine patients in the Group B. Both GGO and DLA were present in two patients in the Group A and nine patients in the Group B. Prone ventilation significantly improved patients’ impaired ratio of arterial partial pressure of oxygen to fraction of inspired oxygen from 12 h after prone positioning compared with that in the supine position. Weaning from mechanical ventilation occurred significantly earlier in the Group A with DLA vs the Group B with DLA (P < 0.001). Twenty-eight-day mortality was significantly lower for the Group A with DLA vs the Group B with DLA (P = 0.035). CONCLUSIONS: These results suggest that prone ventilation could be effective for treating patients with ARDS as showing the DLA. Sciendo 2020-01-31 /pmc/articles/PMC7029406/ /pubmed/32104729 http://dx.doi.org/10.2478/jccm-2020-0003 Text en © 2020 Masayuki Akatsuka, Hiroomi Tatsumi, Naoya Yama, Yoshiki Masuda, published by Sciendo http://creativecommons.org/licenses/by-nc-nd/4.0 This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
spellingShingle Research Article
Akatsuka, Masayuki
Tatsumi, Hiroomi
Yama, Naoya
Masuda, Yoshiki
Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery
title Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery
title_full Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery
title_fullStr Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery
title_full_unstemmed Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery
title_short Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery
title_sort therapeutic evaluation of computed tomography findings for efficacy of prone ventilation in acute respiratory distress syndrome patients with abdominal surgery
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029406/
https://www.ncbi.nlm.nih.gov/pubmed/32104729
http://dx.doi.org/10.2478/jccm-2020-0003
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