俯卧位通气能否改善急性呼吸窘迫综合征患者的氧合并降低死亡率？
Does prone positioning improve oxygenation and reduce mortality in patients with acute respiratory distress syndrome?
作者信息
Henderson William R, Griesdale Donald E G, Dominelli Paolo, Ronco Juan J
出版信息
Can Respir J. 2014 Jul-Aug;21(4):213-5. doi: 10.1155/2014/472136. Epub 2014 Jun 13.
Abstract
The emergence of computed tomography imaging more than 25 years ago led to characterization of acute respiratory distress syndrome (ARDS) as areas of relatively normal lung parenchyma juxtaposed with areas of dense consolidation and atelectasis. Given that this heterogeneity is often dorsally distributed, investigators questioned whether care for ARDS patients in the prone position would lead to improved mortality outcomes. This clinical review discusses the physiological rationale and clinical evidence supporting prone positioning in treating ARDS, in addition to its complications and contraindications.
摘要
25 多年前计算机断层扫描成像技术的出现，使得急性呼吸窘迫综合征（ARDS）的特征表现为相对正常的肺实质区域与致密实变和肺不张区域并存。鉴于这种异质性通常分布在背部，研究人员质疑对 ARDS 患者采用俯卧位护理是否会改善死亡率结局。本临床综述讨论了支持在治疗 ARDS 时采用俯卧位的生理原理和临床证据，以及其并发症和禁忌症。
相似文献
1
Does prone positioning improve oxygenation and reduce mortality in patients with acute respiratory distress syndrome?俯卧位通气能否改善急性呼吸窘迫综合征患者的氧合并降低死亡率？
Can Respir J. 2014 Jul-Aug;21(4):213-5. doi: 10.1155/2014/472136. Epub 2014 Jun 13.
2
Improved Oxygenation After Prone Positioning May Be a Predictor of Survival in Patients With Acute Respiratory Distress Syndrome.俯卧位通气后氧合改善可能是急性呼吸窘迫综合征患者生存的预测指标。
Crit Care Med. 2020 Dec;48(12):1729-1736. doi: 10.1097/CCM.0000000000004611.
3
Prone Ventilation for Patients with Mild or Moderate Acute Respiratory Distress Syndrome.轻度或中度急性呼吸窘迫综合征患者的俯卧位通气
Ann Am Thorac Soc. 2020 Jan;17(1):24-29. doi: 10.1513/AnnalsATS.201906-456IP.
4
Effect of prone positioning on oxygenation and static respiratory system compliance in COVID-19 ARDS vs. non-COVID ARDS.COVID-19 相关 ARDS 与非 COVID-19 相关 ARDS 患者俯卧位对氧合和静态呼吸系统顺应性的影响。
Respir Res. 2021 Aug 6;22(1):220. doi: 10.1186/s12931-021-01819-4.
5
Effect of prone positioning during mechanical ventilation on mortality among patients with acute respiratory distress syndrome: a systematic review and meta-analysis.俯卧位通气对急性呼吸窘迫综合征患者死亡率的影响：系统评价和荟萃分析。
CMAJ. 2014 Jul 8;186(10):E381-90. doi: 10.1503/cmaj.140081. Epub 2014 May 26.
6
Prone positioning for patients intubated for severe acute respiratory distress syndrome (ARDS) secondary to COVID-19: a retrospective observational cohort study.COVID-19 继发严重急性呼吸窘迫综合征（ARDS）患者行气管插管后俯卧位治疗：一项回顾性观察性队列研究。
Br J Anaesth. 2021 Jan;126(1):48-55. doi: 10.1016/j.bja.2020.09.042. Epub 2020 Oct 10.
7
Effect of mechanical ventilation in the prone position on clinical outcomes in patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis.俯卧位机械通气对急性低氧性呼吸衰竭患者临床结局的影响：一项系统评价和荟萃分析。
CMAJ. 2008 Apr 22;178(9):1153-61. doi: 10.1503/cmaj.071802.
8
Positioning of patients with acute respiratory distress syndrome: combining prone and upright makes sense.急性呼吸窘迫综合征患者的体位摆放：俯卧位与仰卧位相结合有意义。
Crit Care. 2011;15(6):1019. doi: 10.1186/cc10560. Epub 2011 Dec 15.
9
Prone positioning use to hasten veno-venous ECMO weaning in ARDS.俯卧位用于加速急性呼吸窘迫综合征患者静脉-静脉体外膜肺氧合的撤机。
Intensive Care Med. 2013 Oct;39(10):1877-9. doi: 10.1007/s00134-013-3007-8. Epub 2013 Jul 9.
10
Acute Respiratory Distress in the Operating Room and Prone Ventilation: A Case Report.手术室中的急性呼吸窘迫与俯卧位通气：一例报告
A A Pract. 2019 Jan 1;12(1):19-21. doi: 10.1213/XAA.0000000000000832.
引用本文的文献
1
Assessing the Impact of the Prone Position on Acute Kidney Injury.评估俯卧位对急性肾损伤的影响。
J Clin Med. 2025 Jan 19;14(2):631. doi: 10.3390/jcm14020631.
2
A Comprehensive Review of Prone Ventilation in the Intensive Care Unit: Challenges and Solutions.重症监护病房俯卧位通气的全面综述：挑战与解决方案
Cureus. 2024 Mar 30;16(3):e57247. doi: 10.7759/cureus.57247. eCollection 2024 Mar.
3
Changes in Driving Pressure vs Oxygenation as Predictor of Mortality in Moderate to Severe Acute Respiratory Distress Syndrome Patients Receiving Prone Position Ventilation.接受俯卧位通气的中重度急性呼吸窘迫综合征患者驱动压与氧合变化对死亡率的预测作用
Indian J Crit Care Med. 2024 Feb;28(2):134-140. doi: 10.5005/jp-journals-10071-24643.
4
Reactive Oxygen Species and Strategies for Antioxidant Intervention in Acute Respiratory Distress Syndrome.急性呼吸窘迫综合征中的活性氧物种与抗氧化干预策略
Antioxidants (Basel). 2023 Nov 18;12(11):2016. doi: 10.3390/antiox12112016.
5
Management of refractory hypoxemia using recruitment maneuvers and rescue therapies: A comprehensive review.使用肺复张手法和挽救治疗对难治性低氧血症的管理：一项综述
Front Vet Sci. 2023 Mar 30;10:1157026. doi: 10.3389/fvets.2023.1157026. eCollection 2023.
6
An appraisal of the methodology and quality of evidence of systematic reviews on the efficacy of prone positional ventilation in adult patients with acute respiratory distress syndrome: an umbrella review.对成人急性呼吸窘迫综合征患者俯卧位通气疗效的系统评价的方法学与证据质量评估：一项伞状综述
Intern Emerg Med. 2023 Apr;18(3):691-709. doi: 10.1007/s11739-022-03174-8. Epub 2022 Dec 30.
7
Prone Cardiopulmonary Resuscitation (CPR) Protocol: A Single-Center Experience at Implementation and Review of Literature.俯卧位心肺复苏术（CPR）方案：单中心实施经验及文献综述
Cureus. 2022 Sep 26;14(9):e29604. doi: 10.7759/cureus.29604. eCollection 2022 Sep.
8
Regional ventilation in spontaneously breathing COVID-19 patients during postural maneuvers assessed by electrical impedance tomography.电断层成像术评估 COVID-19 患者自主呼吸时体位改变后的区域通气。
Acta Anaesthesiol Scand. 2023 Feb;67(2):185-194. doi: 10.1111/aas.14161. Epub 2022 Nov 3.
9
Changes in infant porcine pulmonary tissue oxylipins induced by cardiopulmonary bypass.心肺转流术引起的婴儿猪肺组织氧化应激产物的变化。
Pediatr Res. 2022 Nov;92(5):1274-1281. doi: 10.1038/s41390-022-02125-5. Epub 2022 Jun 9.
10
Effectiveness of prone position in acute respiratory distress syndrome and moderating factors of obesity class and treatment durations for COVID-19 patients: A meta-analysis.COVID-19 患者俯卧位治疗急性呼吸窘迫综合征的效果及其肥胖程度和治疗时间的调节因素：一项荟萃分析。
Intensive Crit Care Nurs. 2022 Oct;72:103257. doi: 10.1016/j.iccn.2022.103257. Epub 2022 Apr 11.
本文引用的文献
1
Prone position.俯卧位。
Curr Opin Crit Care. 2014 Feb;20(1):92-7. doi: 10.1097/MCC.0000000000000059.
2
Body position changes redistribute lung computed-tomographic density in patients with acute respiratory failure: impact and clinical fallout through the following 20 years.体位改变会重新分布急性呼吸衰竭患者的肺部 CT 密度：20 年来的影响和临床后果。
Intensive Care Med. 2013 Nov;39(11):1909-15. doi: 10.1007/s00134-013-3066-x. Epub 2013 Sep 12.
3
Prone positioning in severe acute respiratory distress syndrome.俯卧位通气治疗严重急性呼吸窘迫综合征。
N Engl J Med. 2013 Jun 6;368(23):2159-68. doi: 10.1056/NEJMoa1214103. Epub 2013 May 20.
4
Acute respiratory distress syndrome: prevention and early recognition.急性呼吸窘迫综合征：预防和早期识别。
Ann Intensive Care. 2013 Apr 24;3(1):11. doi: 10.1186/2110-5820-3-11.
5
Acute respiratory distress syndrome: the Berlin Definition.急性呼吸窘迫综合征：柏林定义。
JAMA. 2012 Jun 20;307(23):2526-33. doi: 10.1001/jama.2012.5669.
6
Stress and strain within the lung.肺部的压力和应变。
Curr Opin Crit Care. 2012 Feb;18(1):42-7. doi: 10.1097/MCC.0b013e32834f17d9.
7
Prone positioning: beyond physiology.俯卧位通气：超越生理学范畴
Anesthesiology. 2010 Dec;113(6):1262-4. doi: 10.1097/ALN.0b013e3181fcd97e.
8
Beyond mortality: future clinical research in acute lung injury.超越死亡率：急性肺损伤的未来临床研究。
Am J Respir Crit Care Med. 2010 May 15;181(10):1121-7. doi: 10.1164/rccm.201001-0024WS. Epub 2010 Mar 11.
9
Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis.高与低呼气末正压通气在急性肺损伤和急性呼吸窘迫综合征患者中的应用：系统评价和荟萃分析。
JAMA. 2010 Mar 3;303(9):865-73. doi: 10.1001/jama.2010.218.
10
Prone positioning in patients with moderate and severe acute respiratory distress syndrome: a randomized controlled trial.中重度急性呼吸窘迫综合征患者俯卧位通气：一项随机对照试验。
JAMA. 2009 Nov 11;302(18):1977-84. doi: 10.1001/jama.2009.1614.
Zotero 插件