Girbes Armand R J
Amsterdam UMC. locatie VUmc, afd. Intensive Care, Amsterdam.
Contact: Armand R.J. Girbes (
Ned Tijdschr Geneeskd. 2022 Jul 27;166:D6874.
In mechanically ventilated patients with ARDS, prone positioning has demonstrated improvement, not only in oxygenation but also in survival. Whether early prone positioning of patients with mild hypoxemia and ARDS due to covid-19 improves outcome in terms of survival and prevention of the need for invasive ventilation was recently investigated in a RCT. Physiological reasoning would suggest a potential benefit. But no advantages of prone positioning were found in the study population of 250 patients. However, compliance to the intervention was very low in the intervention group making it practically impossible to assess the effects of the intervention. Therefore, clinicians should still rely on physiological reasoning and individual effects of prone positioning in deemed suitable patients.
在患有急性呼吸窘迫综合征（ARDS）的机械通气患者中，俯卧位不仅已证明可改善氧合，还能提高生存率。最近在一项随机对照试验（RCT）中研究了因新冠病毒-19导致轻度低氧血症和ARDS的患者早期采用俯卧位是否能在生存及预防有创通气需求方面改善预后。从生理学角度推理表明可能存在益处。但在250例患者的研究人群中未发现俯卧位有任何优势。然而，干预组对干预措施的依从性非常低，实际上无法评估干预效果。因此，临床医生仍应依靠生理学推理以及在认为合适的患者中俯卧位的个体效应。
