[Lateralization as alternative to static prone decubitus in patients with ARDS]. / Lateralización como alternativa al decúbito prono estático en pacientes con SDRA.

UNLABELLED: According to Phillips, Continuous Lateral Rotation (CLR) or Kinetic Therapy (KT) together with the technological advances obtain some important benefits in mechanically ventilated patients. OBJECTIVE: Compare Static Prone Decubitus (PD) with DP in CRL. PATIENTS AND METHODS: We analyzed 2 groups with a total of 41 patients in the period of January 1998 to April 2003. The DP group (25 patients) remained static and the lateral group (16 patients) in CLR every 2 h. The groups had 56 +/- 16 vs 64 +/- 17 years, 77 +/- 20 vs 71 +/- 23 kg and 24% vs 31% of survival, respectively. RESULTS: We maintained the PD 37 +/- 30 vs 27 +/- 36 h for group 1 and 2. The response as Responders is 68% and 69%. pO2/FiO2 of supine pre-DP to supine post-DP is 79 +/- 21 to 146 +/- 68 versus 80 +/- 20 to 138 +/- 57 and pulmonary compliance 22 +/- 10 to 21 +/- 10 vs 31 +/- 10 to 32 +/- 9. Mean blood pressure of S to S was 87 +/- 16 to 85 +/- 15 vs 82 +/- 10 to 80 +/- 9, and mean Heart rate 108 +/- 21 to 95 +/- 24 vs 85 +/- 32 to 75 +/- 28. Complications by groups were: facial edema of 84% vs 63%, gastric retention 36% to 38%, vomiting/regurgitation 12% to 0%, epistaxis 8% to 31%. Pressure Sore (PS) Incidence decreased from 36% to 12%, together with seriousness. CONCLUSION: We consider that lateralization if PD is a technique comparable to static PD on the respiratory and hemodynamics level. CLR in PD may prevent some complications.

Lateralización como alternativa al decúbito prono estático en pacientes con SDRA / Lateralization as alternative to static prone decubitus in patients with ARDS

Según Phillips1, la continua rotación lateralizada (RCL) o terapia cinética (TC) unida a los avances tecnológicos, obtiene unos importantes beneficios en los pacientes ventilados mecánicamente. Objetivo. Comparar el decúbito prono (DP) estático con el DP en RCL. Pacientes y métodos. Se analizaron 2 grupos con un total de 41 pacientes en el período enero de 1998 hasta abril de 2003. El grupo DP (25 pacientes) permaneció estático y el grupo lateralizado (16 pacientes) en RCL cada 2 h. Los grupos tenían 56 ± 16 frente a 64 ± 17 años, 77 ± 20 frente a 71 ± 23 kg y un 24 frente a un 31% de supervivencia, respectivamente. Resultados. Se mantuvo el DP 37 ± 30 frente a 27 ± 36 h por grupos 1 y 2. La respuesta como respondedores fue del 68 y del 69%. La pO2/FiO2 de supino pre-DP a supino post-DP fue de 79 ± 21 a 146 ± 68 frente a 80 ± 20 a 138 ± 57, y la distensibilidad pulmonar 22 ± 10 a 21 ± 10 frente a 31 ± 10 a 32 ± 9. La presión arterial media de S a S fue de 87 ± 16 a 85 ± 15 frente a 82 ± 10 a 80 ± 9, y la frecuencia cardíaca media 108 ± 21 a 95 ± 24 frente a 85 ± 32 a 75 ± 28. Las complicaciones por grupos fueron: edema facial el 84 frente al 63%; retención gástrica el 36 frente al 38%; vómito/regurgitación el 12 frente al 0%, y epistaxis el 8 frente al 31%. La incidencia de úlceras por presión (UP) se redujo del 36 al 12% junto con la gravedad. Conclusión. Se considera que la lateralización en DP es una técnica equiparable al DP estático respiratorio y hemodinámico. La RCL en DP puede prevenir algunas complicaciones

According to Phillips, Continuous Lateral Rotation (CLR) or Kinetic Therapy (KT) together with the technological advances obtain some important benefits in mechanically ventilated patients. Objective. Compare Static Prone Decubitus (PD) with DP in CRL. Patients and methods. We analyzed 2 groups with a total of 41 patients in the period of January 1998 to April 2003. The DP group (25 patients) remained static and the lateral group (16 patients) in CLR every 2 h. The groups had 56 ± 16 vs 64 ± 17 years, 77 ± 20 vs 71 ± 23 kg and 24% vs 31% of survival, respectively. Results. We maintained the PD 37 ± 30 vs 27 ± 36 h for group 1 and 2. The response as Responders is 68% and 69%. pO2/FiO2 of supine pre-DP to supine post-DP is 79 ± 21 to 146 ± 68 versus 80 ± 20 to 138 ± 57 and pulmonary compliance 22 ± 10 to 21 ± 10 vs 31 ± 10 to 32 ± 9. Mean blood pressure of S to S was 87 ± 16 to 85 ± 15 vs 82 ± 10 to 80 ± 9, and mean Heart rate 108 ± 21 to 95 ± 24 vs 85 ± 32 to 75 ± 28. Complications by groups were: facial edema of 84% vs 63%, gastric retention 36% to 38%, vomiting/regurgitation 12% to 0%, epistaxis 8% to 31%. Pressure Sore (PS) Incidence decreased from 36% to 12%, together with seriousness. Conclusion. We consider that lateralization if PD is a technique comparable to static PD on the respiratory and hemodynamics level. CLR in PD may prevent some complications