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Lateral position during severe mono-lateral pneumonia: an experimental study.


ABSTRACT: Patients with mono-lateral pneumonia and severe respiratory failure can be positioned in lateral decubitus, with the healthy lung dependent, to improve ventilation-perfusion coupling. Oxygenation response to this manoeuvre is heterogeneous and derecruitment of dependent lung has not been elucidated. Nine pigs (32.2?±?1.2 kg) were sedated and mechanically ventilated. Mono-lateral right-sided pneumonia was induced with intrabronchial challenge of Pseudomonas aeruginosa. After 24 h, lungs were recruited and the animals were randomly positioned on right or left side. After 3 h of lateral positioning, the animals were placed supine; another recruitment manoeuvre was performed, and the effects of contralateral decubitus were assessed. Primary outcome was lung ultrasound score (LUS) of the dependent lung after 3-h lateral positioning. LUS of the left non-infected lung worsened while positioned in left-lateral position (from 1.33?±?1.73 at baseline to 6.78?±?4.49; p?=?0.005). LUS of the right-infected lung improved when placed upward (9.22?±?2.73 to 6.67?±?3.24; p?=?0.09), but worsened in right-lateral position (7.78?±?2.86 to 13.33?±?3.08; p?

SUBMITTER: Meli A 

PROVIDER: S-EPMC7653044 | BioStudies | 2020-01-01

REPOSITORIES: biostudies

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