Gordon Ayla, Rabold Erica, Thirumala Raghukumar, Husain Ahmad Alhaj, Patel Samir, Cheema Tariq
Division of Pulmonary-Critical Care (Drs Gordon, Rabold, Thirumala, Husain, and Cheema) and Internal Medicine Residency, Department of Medicine (Dr Patel), Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania.
Crit Care Nurs Q. 2019 Oct/Dec;42(4):371-375. doi: 10.1097/CNQ.0000000000000277.
Adult respiratory distress syndrome (ARDS) is a clinical entity characterized by hypoxemic respiratory failure in the setting of noncardiogenic pulmonary edema. It is associated with significant morbidity and mortality. Prone positioning is a beneficial strategy in patients with severe ARDS because it improves alveolar recruitment, ventilation/perfusion (V/Q) ratio, and decreases lung strain. The outcome is improved oxygenation, decreased severity of lung injury, and, subsequently, mortality benefit. In this article, we discuss the physiology of prone positioning on chest mechanics and V/Q ratio, the placement and maintenance of patients in the prone position with use of a prone bed and the current literature regarding benefits of prone positioning in patients with ARDS.
成人呼吸窘迫综合征（ARDS）是一种临床病症，其特征为在非心源性肺水肿情况下出现低氧性呼吸衰竭。它与显著的发病率和死亡率相关。俯卧位通气是重症ARDS患者的一种有益策略，因为它可改善肺泡复张、通气/血流（V/Q）比值，并减轻肺应变。结果是氧合改善、肺损伤严重程度降低，进而带来死亡率获益。在本文中，我们讨论俯卧位通气对胸部力学和V/Q比值的生理影响、使用俯卧床将患者置于俯卧位的方法及维持措施，以及目前关于ARDS患者俯卧位通气获益的文献。
