Oshima Yoshiaki, Okazaki Naoto, Funaki Kazumi, Takahashi Shunsaku, Harada Tomomi, Otsuki Akihiro, Inagaki Yoshimi
Division of Anesthesiology and Critical Care Medicine, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
Department of Anesthesiology, Yonago Medical Center, Yonago 683-0006, Japan.
Yonago Acta Med. 2021 May 2;64(2):229-233. doi: 10.33160/yam.2021.05.012. eCollection 2021 May.
Ventilation in the prone position improves the prognosis of patients with severe acute respiratory distress syndrome (ARDS). Contraindications to ventilation in this position include unstable systemic circulation. Only a few reports exist on the effects of prone ventilation in respiratory failure on systemic circulation. This animal study compared systemic hemodynamic changes between supine and prone positions in anesthetized rabbits under acute systemic hypoxia (breathing 15% O). Cardiac output and the systemic O extraction ratio increased under the hypoxia, but only in the supine group. Besides, the rate pressure product was higher in the prone group than in the supine group. This study showed that prone ventilation increases myocardial O consumption and suppresses compensatory mechanisms to maintain aerobic metabolism during systemic hypoxia. First of all, it will be necessary to examine the effect of prone ventilation on the O supply-demand balance in the ARDS model.
俯卧位通气可改善重症急性呼吸窘迫综合征（ARDS）患者的预后。该体位通气的禁忌证包括不稳定的体循环。关于呼吸衰竭时俯卧位通气对体循环影响的报道较少。这项动物研究比较了急性全身缺氧（吸入15%氧气）麻醉兔仰卧位和俯卧位时的全身血流动力学变化。缺氧时心输出量和全身氧摄取率增加，但仅在仰卧位组出现。此外，俯卧位组的心率血压乘积高于仰卧位组。本研究表明，俯卧位通气会增加心肌氧消耗，并抑制全身缺氧期间维持有氧代谢的代偿机制。首先，有必要在ARDS模型中研究俯卧位通气对氧供需平衡的影响。
