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Akatsuka M, Tatsumi H, Yama N, et al. Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery. J Crit Care Med (Targu Mures). 2020;6(1):32-40doi: 10.2478/jccm-2020-0003.
Akatsuka, M., Tatsumi, H., Yama, N., & Masuda, Y. (2020). Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery. Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures), 6(1), 32-40. https://doi.org/10.2478/jccm-2020-0003
Akatsuka, Masayuki, et al. "Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery." Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) vol. 6,1 (2020): 32-40. doi: https://doi.org/10.2478/jccm-2020-0003
Akatsuka M, Tatsumi H, Yama N, Masuda Y. Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery. J Crit Care Med (Targu Mures). 2020 Jan 31;6(1):32-40. doi: 10.2478/jccm-2020-0003. eCollection 2020 Jan. PMID: 32104729; PMCID: PMC7029406.
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J Crit Care Med (Targu Mures). 2020 Jan 31;6(1):32-40. doi: 10.2478/jccm-2020-0003. eCollection 2020 Jan.

Therapeutic Evaluation of Computed Tomography Findings for Efficacy of Prone Ventilation in Acute Respiratory Distress Syndrome Patients with Abdominal Surgery.

Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures)

Masayuki Akatsuka, Hiroomi Tatsumi, Naoya Yama, Yoshiki Masuda

Affiliations

  1. Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
  2. Department of Anaesthesiology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
  3. Department of Diagnostic Radiology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.

PMID: 32104729 PMCID: PMC7029406 DOI: 10.2478/jccm-2020-0003

Abstract

INTRODUCTION: In Acute Respiratory Distress Syndrome (ARDS), the heterogeneity of lung lesions results in a mis-match between ventilation and perfusion, leading to the development of hypoxia. The study aimed to examine the association between computed tomographic (CT scan) lung findings in patients with ARDS after abdominal surgery and improved hypoxia and mortality after prone ventilation.

MATERIAL AND METHODS: A single site, retrospective observational study was performed at the Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan, between 1st January 2004 and 31st October 2018. Patients were allocated to one of two groups after CT scanning according to the presence of ground-glass opacity (GGO) or alveolar shadow with predominantly dorsal lung atelectasis (DLA) on lung CT scan images. Also, Patients were divided into a prone ventilation group and a supine ventilation group when the treatment for ARDS was started.

RESULTS: We analyzed data for fifty-one patients with ARDS following abdominal surgery. CT scans confirmed GGO in five patients in the Group A and in nine patients in the Group B, and DLA in 17 patients in the Group A and nine patients in the Group B. Both GGO and DLA were present in two patients in the Group A and nine patients in the Group B. Prone ventilation significantly improved patients' impaired ratio of arterial partial pressure of oxygen to fraction of inspired oxygen from 12 h after prone positioning compared with that in the supine position. Weaning from mechanical ventilation occurred significantly earlier in the Group A with DLA vs the Group B with DLA (P < 0.001). Twenty-eight-day mortality was significantly lower for the Group A with DLA vs the Group B with DLA (P = 0.035).

CONCLUSIONS: These results suggest that prone ventilation could be effective for treating patients with ARDS as showing the DLA.

© 2020 Masayuki Akatsuka, Hiroomi Tatsumi, Naoya Yama, Yoshiki Masuda, published by Sciendo.

Keywords: acute respiratory distress syndrome; computed tomography; prone position

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