Xu Jiahao, Fu Fangjie, Ding Qianrong, Wang Bo, Ji Peng
Jiahao Xu is a resident physician, Department of Critical Care Medicine, West China Xiamen Hospital of Sichuan University, Xiamen, China.
Fangjie Fu is a resident physician, Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China.
Crit Care Nurse. 2025 Feb 1;45(1):29-35. doi: 10.4037/ccn2025831.
Prone ventilation is a standard treatment for acute respiratory distress syndrome, and its clinical benefits are well established. However, implementing prone positioning safely and effectively is challenging in patients who are pregnant, have intra-abdominal hypertension, or are in other high-risk groups.
A patient in the third trimester of pregnancy (28 weeks and 6 days of gestation) developed a body temperature of 39 °C and severe respiratory distress. She was transferred to the intensive care unit, received noninvasive ventilation, and ultimately underwent endotracheal intubation. Because her oxygenation index remained below 100, she received a diagnosis of severe acute respiratory distress syndrome.
The patient was safely placed in the prone position with a swim ring while receiving venovenous extracorporeal membrane oxygenation. During this period, her intra-abdominal pressure did not increase significantly.
The fetus was delivered by cesarean birth, and the patient was transferred to the general ward after extubation.
This case report describes the use of prone positioning in a pregnant patient. The report offers critical care nurses insights into the clinical management of patients who are pregnant or have intra-abdominal hypertension.
俯卧位通气是急性呼吸窘迫综合征的标准治疗方法,其临床益处已得到充分证实。然而,对于孕妇、有腹腔内高压或属于其他高危群体的患者,安全有效地实施俯卧位具有挑战性。
一名妊娠晚期(妊娠28周零6天)的患者体温升至39°C,并出现严重呼吸窘迫。她被转入重症监护病房,接受了无创通气,最终接受了气管插管。由于她的氧合指数仍低于100,她被诊断为重度急性呼吸窘迫综合征。
在接受静脉-静脉体外膜肺氧合治疗时,患者使用游泳圈安全地处于俯卧位。在此期间,她的腹腔内压力没有显著增加。
胎儿通过剖宫产分娩,患者拔管后转入普通病房。
本病例报告描述了在一名孕妇中使用俯卧位的情况。该报告为重症护理护士提供了对孕妇或有腹腔内高压患者临床管理的见解。