Paradoxical Positioning: Does "Head Up" Always Improve Mechanics and Lung Protection?

ABSTRACT:

Objectives

Head-elevated body positioning, a default clinical practice, predictably increases end-expiratory transpulmonary pressure and aerated lung volume. In acute respiratory distress syndrome (ARDS), however, the net effect of such vertical inclination on tidal mechanics depends upon whether lung recruitment or overdistension predominates. We hypothesized that in moderate to severe ARDS, bed inclination toward vertical unloads the chest wall but adversely affects overall respiratory system compliance (C rs ).

Design

Prospective physiologic study.

Setting

Two medical ICUs in the United States.

Patients

Seventeen patients with ARDS, predominantly moderate to severe.

Intervention

Patients were ventilated passively by volume control. We measured airway

SUBMITTER: Selickman J 

PROVIDER: S-EPMC9555829 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature