Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery
, , und | 31. Jan. 2020
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Article Category: Research Article
Online veröffentlicht: 31. Jan. 2020
Seitenbereich: 32 - 40
Eingereicht: 27. Sept. 2019
Akzeptiert: 15. Jan. 2020
DOI: https://doi.org/10.2478/jccm-2020-0003
Schlüsselwörter
© 2020 Masayuki Akatsuka, Hiroomi Tatsumi, Naoya Yama, Yoshiki Masuda, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
Fig. 1
Fig. 2
Demographic data of patients in whom CT scan shows dorsal lung atelectasis and ground glass opacification
| Dorsal Lung Atelectasis | Ground Glass Opacification | |||||
|---|---|---|---|---|---|---|
| Group A | Group B | p | Group A | Group B | p | |
| Number | 17 | 9 | 5 | 9 | ||
| Age (year-old) | 69.2 ±10.7 | 69.4 ±13.2 | 0.965 | 80.4 ±5.7 | 65.7 ±13.1 | 0.036 |
| Male / Female | 11/6 | 5 / 4 | 0.692 | 4 / 1 | 8 / 1 | 1.000 |
| APACHE II | 19.8 ±5.2 | 20.9 ±8.6 | 0.679 | 20.8 ±3.5 | 19.4 ±5.9 | 0.649 |
| SOFA | 7.5 ±3.5 | 8.4 ±3.6 | 0.512 | 7.4 ±1.9 | 6.3 ±2.5 | 0.435 |
| Surgical site | ||||||
| Upper tract | 6 | 3 | 5 | 4 | ||
| Lower tract | 10 | 6 | 0 | 5 | ||
| Miscellaneous | 1 | 0 | 0 | 0 | ||
| Drug therapy Steroid, n(%) | 2(11.7) | 2(22.2) | 0.591 | 2 (40.0) | 6 (66.7) | 0.580 |
| Ventilator settings at the start of the study FiO2 | 0.7 ±0.2 | 0.6± 0.2 | 0.239 | 0.7 ±0.2 | 0.7 ±0.1 | 0.884 |
| PEEP(cmH2O) | 9.8 ±1.0 | 9.0 ±4.7 | 0.515 | 12.0 ±4.7 | 9.1±1.1 | 0.093 |
| Peak pressure (cmH20) | 19.4 ±3.9 | 16.2 ±5.2 | 0.385 | 19.4 ±7.3 | 19.2 ±4.1 | 0.953 |
| Respiratory rate | 22.2 ±7.3 | 19.9 ±5.5 | 0.420 | 18.4 ±6.1 | 25.1 ±6.9 | 0.097 |
| PaO2/FiO2 | ||||||
| At the time after the start of the study | ||||||
| Oh | 157 ± 44 | 173 ±32 | 0.325 | 151 ±45 | 150 ±21 | 0.958 |
| 72 h | 307 ± 62 | 214 ±62 | 0.0010 | 233 ± 89 | 219 ±70 | 0.748 |
Patients’ demographic data
| Group A | Group B | P | |
|---|---|---|---|
| Number | 24 | 27 | |
| Age (year-old) | 71.0 ± 11.2 | 68.9 ± 12.2 | 0.508 |
| Male / Female | 17 / 7 | 18 / 9 | 0.772 |
| APACHE II | 21.0 ± 5.8 | 20.4 ± 6.4 | 0.734 |
| SOFA | 7.3 ± 3.1 | 7.9 ± 3.4 | 0.469 |
| Shock, n (%) | 9 (37.5) | 14 (51.9) | 0.400 |
| Surgical site | |||
| Upper tract | 15 | 12 | 0.162 |
| Lower tract | 8 | 15 | |
| Miscellaneous | 1 | 0 | |
| Drug therapy | |||
| Steroid, n (%) | 5 (20.8) | 11 (40.7) | 0.145 |
| Ventilator settings at the start of the study | |||
| PEEP (cmH2O) | 10.3 ± 2.3 | 9.0 ± 3.2 | 0.116 |
| Peak pressure (cmH2O) | 19.5 ± 4.5 | 18.3 ± 5.7 | 0.426 |
| Respiratory rate | 21.5 ± 6.8 | 22.6 ± 7.7 | 0.584 |
| PaO2 /FiO2 | |||
| At the start of mechanical ventilation | 118 ± 41 | 141 ± 42 | 0.030 |
| At the time after the start of the study | |||
| 0 h | 154 ± 41 | 156 ± 30 | 0.841 |
| 12 h | 223 ± 63 | 166 ± 46 | < 0.001 |
| 24 h | 245 ± 82 | 182 ± 49 | 0.002 |
| 48 h | 265 ± 76 | 202 ± 46 | < 0.001 |
| 72 h | 290 ± 75 | 226 ± 65 | 0.002 |
| CT scan findings | |||
| GGO | 5 | 9 | 0.243 |
| DLA | 17 | 9 | |
| GGO + DLA | 2 | 9 | |
| Ventilator free days | 17.4 ± 9.1 | 11.5 ± 9.8 | 0.032 |
| ICU free days | 14.4 ± 9.1 | 10.0 ± 9.2 | 0.095 |
| 28-day mortality, n (%) | 4 (16.7) | 10 (37.0) | 0.127 |
| 90-day mortality, n (%) | 5 (20.8) | 13 (48.1) | 0.048 |
Effect of prone ventilation on ventilator-free days, ICU-free days, and 28-day mortality in patients with CT SCAN findings of dorsal lung atelectasis or ground-glass opacification
| Dorsal Lung Atelectasis | Ground Glass Opacification | |||||
|---|---|---|---|---|---|---|
| Group A | Group B | Group A | Group B | |||
| Ventilator free days | 20.2 ±6.9 | 5.8 ±7.8 | < 0.001 | 7.8 ±11.0 | 11.9 ±10.3 | 0.390 |
| ICU free days | 16.9 ±7.5 | 4.1 ±7.2 | < 0.001 | 7.4 ±10.4 | 11.8 ±9.8 | 0.339 |
| 28-day mortality, n (%) | 1(5.9) | 4 (44.4) | 0.035 | 3 (60.0) | 4 (44.4) | 1.000 |
| 90-day mortality, n (%) | 2(11.8) | 5(55.6) | 0.028 | 3 (60.0) | 5(55.6) | 1.000 |