Prone position improves expiratory airway mechanics in severe chronic bronchitis
Based on lung parenchyma-airways' interdependence, the present authors hypothesised that prone positioning may reduce airway resistance in severe chronic bronchitis. A total of 10 anaesthetised/mechanically ventilated patients were enrolled. Partitioned respiratory system (RS) mechanics during...
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| Veröffentlicht in: | The European respiratory journal 2005-02, Vol.25 (2), p.259-268 |
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| creator | Mentzelopoulos, S. D Roussos, C Zakynthinos, S. G |
| description | Based on lung parenchyma-airways' interdependence, the present authors hypothesised that prone positioning may reduce airway resistance in severe chronic bronchitis. A total of 10 anaesthetised/mechanically ventilated patients were enrolled. Partitioned respiratory system (RS) mechanics during iso-flow experiments (flow = 0.91 L x s(-1), tidal volume (VT) varied within 0.2-1.2 L), haemodynamics, gas-exchange, expiratory airway resistance (Raw,exp), functional residual capacity (FRC), change in FRC (DeltaFRC), end-expiratory lung volume (EELV), expiratory airway resistance at EELV (Raw,exp,EELV), intrinsic positive end-expiratory pressure (PEEPi), and mean end-expiratory flow were determined in baseline semirecumbent (SRBAS), prone, and post-prone semirecumbent (SRPP) postures. Pronation versus SRBAS resulted in significantly reduced Raw,exp (at VT > or =0.8 L), Raw,exp,EELV (18.3+/-1.4 versus 31.6+/-2.6 cm H2O x L(-1) x s(-1)), inspiratory airway resistance (at VT > or =1.0 L), static lung elastance (at VT < or =0.6 L), "additional" RS/lung resistance (at a range of VTs), DeltaFRC (0.35+/-0.03 versus 0.47+/-0.03 L), EELV (4.92+/-0.49 versus 5.65+/-0.65 L), RS/lung PEEPi (6.7+/-1.1/5.4+/-0.6 versus 8.9+/-1.7/7.8+/-1.1 cm H2O), mean end-expiratory flow (63.9+/-4.2 versus 47.9+/-4.0 mL x s(-1)), and shunt fraction (0.16+/-0.03 versus 0.21+/-0.03); benefits were reversed in SRPP. In severe chronic bronchitis, prone positioning reduces airway resistance and dynamic hyperinflation. |
| doi_str_mv | 10.1183/09031936.05.00094704 |
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Pronation versus SRBAS resulted in significantly reduced Raw,exp (at VT > or =0.8 L), Raw,exp,EELV (18.3+/-1.4 versus 31.6+/-2.6 cm H2O x L(-1) x s(-1)), inspiratory airway resistance (at VT > or =1.0 L), static lung elastance (at VT < or =0.6 L), "additional" RS/lung resistance (at a range of VTs), DeltaFRC (0.35+/-0.03 versus 0.47+/-0.03 L), EELV (4.92+/-0.49 versus 5.65+/-0.65 L), RS/lung PEEPi (6.7+/-1.1/5.4+/-0.6 versus 8.9+/-1.7/7.8+/-1.1 cm H2O), mean end-expiratory flow (63.9+/-4.2 versus 47.9+/-4.0 mL x s(-1)), and shunt fraction (0.16+/-0.03 versus 0.21+/-0.03); benefits were reversed in SRPP. 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D</creatorcontrib><creatorcontrib>Roussos, C</creatorcontrib><creatorcontrib>Zakynthinos, S. G</creatorcontrib><title>Prone position improves expiratory airway mechanics in severe chronic bronchitis</title><title>The European respiratory journal</title><addtitle>Eur Respir J</addtitle><description>Based on lung parenchyma-airways' interdependence, the present authors hypothesised that prone positioning may reduce airway resistance in severe chronic bronchitis. A total of 10 anaesthetised/mechanically ventilated patients were enrolled. Partitioned respiratory system (RS) mechanics during iso-flow experiments (flow = 0.91 L x s(-1), tidal volume (VT) varied within 0.2-1.2 L), haemodynamics, gas-exchange, expiratory airway resistance (Raw,exp), functional residual capacity (FRC), change in FRC (DeltaFRC), end-expiratory lung volume (EELV), expiratory airway resistance at EELV (Raw,exp,EELV), intrinsic positive end-expiratory pressure (PEEPi), and mean end-expiratory flow were determined in baseline semirecumbent (SRBAS), prone, and post-prone semirecumbent (SRPP) postures. Pronation versus SRBAS resulted in significantly reduced Raw,exp (at VT > or =0.8 L), Raw,exp,EELV (18.3+/-1.4 versus 31.6+/-2.6 cm H2O x L(-1) x s(-1)), inspiratory airway resistance (at VT > or =1.0 L), static lung elastance (at VT < or =0.6 L), "additional" RS/lung resistance (at a range of VTs), DeltaFRC (0.35+/-0.03 versus 0.47+/-0.03 L), EELV (4.92+/-0.49 versus 5.65+/-0.65 L), RS/lung PEEPi (6.7+/-1.1/5.4+/-0.6 versus 8.9+/-1.7/7.8+/-1.1 cm H2O), mean end-expiratory flow (63.9+/-4.2 versus 47.9+/-4.0 mL x s(-1)), and shunt fraction (0.16+/-0.03 versus 0.21+/-0.03); benefits were reversed in SRPP. In severe chronic bronchitis, prone positioning reduces airway resistance and dynamic hyperinflation.</description><subject>Aged</subject><subject>Airway Resistance - physiology</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Bronchitis, Chronic - physiopathology</subject><subject>Chronic obstructive pulmonary disease, asthma</subject><subject>Female</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pneumology</subject><subject>Prone Position - physiology</subject><subject>Pulmonary Gas Exchange - physiology</subject><subject>Respiratory Function Tests</subject><subject>Respiratory Mechanics - physiology</subject><issn>0903-1936</issn><issn>1399-3003</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkEtvEzEUhS0EomnhHyDkDewm3OvX2EtUFahUiS5gbXmcO4yreQQ7acm_x1FTZXXu4jufrg5jHxDWiFZ-AQcSnTRr0GsAcKoF9YqtUDrXSAD5mq2OSHNkLthlKQ8AaJTEt-wCtbFKWLdi9_d5mYlvl5J2aZl5mrZ5eaTC6d825bBb8oGHlJ_CgU8UhzCnWHiaeaFHysTjUOsp8q5GHKqivGNv-jAWen_KK_b7282v6x_N3c_vt9df75qoEHeNI7GRIiK0aJUxFrsA9ZBWdEqFTeiod7qzahOjbqVRrTW6DQpsH60OCuUV-_zsrf_-3VPZ-SmVSOMYZlr2xZtWOqjKCqpnMOallEy93-Y0hXzwCP64pH9Z0oP2L0vW2seTf99NtDmXTtNV4NMJCCWGsc9hjqmcOaOFRqHO3JD-DE8pky9TGMeqRU_5QWgvvNBO_geWY4hf</recordid><startdate>20050201</startdate><enddate>20050201</enddate><creator>Mentzelopoulos, S. 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G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prone position improves expiratory airway mechanics in severe chronic bronchitis</atitle><jtitle>The European respiratory journal</jtitle><addtitle>Eur Respir J</addtitle><date>2005-02-01</date><risdate>2005</risdate><volume>25</volume><issue>2</issue><spage>259</spage><epage>268</epage><pages>259-268</pages><issn>0903-1936</issn><eissn>1399-3003</eissn><abstract>Based on lung parenchyma-airways' interdependence, the present authors hypothesised that prone positioning may reduce airway resistance in severe chronic bronchitis. A total of 10 anaesthetised/mechanically ventilated patients were enrolled. Partitioned respiratory system (RS) mechanics during iso-flow experiments (flow = 0.91 L x s(-1), tidal volume (VT) varied within 0.2-1.2 L), haemodynamics, gas-exchange, expiratory airway resistance (Raw,exp), functional residual capacity (FRC), change in FRC (DeltaFRC), end-expiratory lung volume (EELV), expiratory airway resistance at EELV (Raw,exp,EELV), intrinsic positive end-expiratory pressure (PEEPi), and mean end-expiratory flow were determined in baseline semirecumbent (SRBAS), prone, and post-prone semirecumbent (SRPP) postures. Pronation versus SRBAS resulted in significantly reduced Raw,exp (at VT > or =0.8 L), Raw,exp,EELV (18.3+/-1.4 versus 31.6+/-2.6 cm H2O x L(-1) x s(-1)), inspiratory airway resistance (at VT > or =1.0 L), static lung elastance (at VT < or =0.6 L), "additional" RS/lung resistance (at a range of VTs), DeltaFRC (0.35+/-0.03 versus 0.47+/-0.03 L), EELV (4.92+/-0.49 versus 5.65+/-0.65 L), RS/lung PEEPi (6.7+/-1.1/5.4+/-0.6 versus 8.9+/-1.7/7.8+/-1.1 cm H2O), mean end-expiratory flow (63.9+/-4.2 versus 47.9+/-4.0 mL x s(-1)), and shunt fraction (0.16+/-0.03 versus 0.21+/-0.03); benefits were reversed in SRPP. In severe chronic bronchitis, prone positioning reduces airway resistance and dynamic hyperinflation.</abstract><cop>Leeds</cop><pub>Eur Respiratory Soc</pub><pmid>15684289</pmid><doi>10.1183/09031936.05.00094704</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Airway Resistance - physiology Analysis of Variance Biological and medical sciences Bronchitis, Chronic - physiopathology Chronic obstructive pulmonary disease, asthma Female Hemodynamics - physiology Humans Male Medical sciences Middle Aged Pneumology Prone Position - physiology Pulmonary Gas Exchange - physiology Respiratory Function Tests Respiratory Mechanics - physiology |
| title | Prone position improves expiratory airway mechanics in severe chronic bronchitis |
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