Breiburg A N, Aitken L, Reaby L, Clancy R L, Pierce J D
University of Kansas Medical Center, School of Nursing, Kansas City 66160-7504, USA.
J Adv Nurs. 2000 Oct;32(4):922-9.
This article presents an overview of a literature review on how prone positioning can alleviate pathophysiological changes in ARDS and improve ventilation and perfusion. Improvement of gas exchange, efficiency of oxygenation and lung function are emphasized. Literature on the pathophysiology of ARDS, and the physiological effects of prone positioning on haemodynamics and lung function is examined. There are both advantages and disadvantages in turning a patient from the supine to the prone position. There are also contraindications in rotating between the supine and prone positions. Nevertheless, by rotating patients with ARDS, it is possible to achieve a significant improvement in A-aDO2, decrease shunting, and therefore improve oxygenation without use of expensive, invasive and experimental procedures. Placing patients with ARDS in the prone position can reduce inspiratory oxygen concentrations and peak inspiratory pressures, which minimizes the chance for barotrauma and the iatrogenic effects of hyperventilation oxygen toxicity.
本文概述了一篇关于俯卧位如何缓解急性呼吸窘迫综合征（ARDS）的病理生理变化并改善通气和灌注的文献综述。重点强调了气体交换的改善、氧合效率和肺功能。对ARDS的病理生理学以及俯卧位对血流动力学和肺功能的生理影响的文献进行了研究。将患者从仰卧位转为俯卧位既有优点也有缺点。在仰卧位和俯卧位之间转换也存在禁忌证。然而，通过让ARDS患者翻身，可以在不使用昂贵、侵入性和实验性程序的情况下，显著改善肺泡-动脉血氧分压差（A-aDO2），减少分流，从而改善氧合。将ARDS患者置于俯卧位可降低吸入氧浓度和吸气峰压，从而将气压伤和高通气氧中毒的医源性影响的可能性降至最低。
