蛛网膜下腔出血所致呼吸功能障碍患者的清醒俯卧位：一例报告
Awake prone positioning in a patient with respiratory impairment due to subarachnoid hemorrhage: a case report.
作者信息
Pacchiarini Giorgia, Geraldini Federico, De Cassai Alessandro, Aviani Fulvio Giulia, Boscolo Annalisa, Zarantonello Francesco, Navalesi Paolo, Munari Marina
机构信息
Department of Medicine, University of Padua, Padua, Italy.
Sant'Antonio Anesthesia and Intensive Care Unit, University-Hospital of Padua, Padua, Italy.
出版信息
J Med Case Rep. 2025 May 28;19(1):255. doi: 10.1186/s13256-025-05311-1.
BACKGROUND
Prone positioning has been shown to be an effective rescue strategy in severe acute respiratory distress syndrome and was widely used during the coronavirus disease 2019 pandemic, both in mechanically ventilated and in awake patients. Subarachnoid hemorrhage is often associated with respiratory failure. Prone positioning has been used in brain-injured patients, but concerns relating to neurological complications from intracranial hypertension still remain.
CASE PRESENTATION
We report the case of a 59-year-old Italian patient with subarachnoid hemorrhage who safely underwent awake prone positioning after deterioration of respiratory function.
CONCLUSIONS
In this report, we show that awake pronation is possible in patients with subarachnoid hemorrhage. However, careful monitoring of Intracranial pressure and clinical examination may be the keys to successful application of this procedure.
背景
俯卧位通气已被证明是治疗严重急性呼吸窘迫综合征的一种有效挽救策略，并在2019冠状病毒病大流行期间被广泛应用于机械通气患者和清醒患者。蛛网膜下腔出血常伴有呼吸衰竭。俯卧位通气已应用于脑损伤患者，但颅内高压引起神经并发症的担忧仍然存在。
病例报告
我们报告一例59岁意大利蛛网膜下腔出血患者，其在呼吸功能恶化后安全地接受了清醒俯卧位通气。
结论
在本报告中，我们表明蛛网膜下腔出血患者可以进行清醒俯卧位通气。然而，仔细监测颅内压和临床检查可能是成功应用该操作的关键。
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