![]() ![]() Since the first description of ARDS, it became evident that mechanical ventilation per se can worsen lung damage, spread systemic inflammation and affect outcome and a new nosologic entity was defined, namely ventilator-induced lung injury (VILI). The change in the mechanical properties of the lung is usually attributed to lung recruitment with an increase in lung resting volume and to a lower vertical pleural pressure gradient in prone position, with consequent more homogenous distribution of transpulmonary pressure, lung inflation and thus ventilation. The oxygenation benefit is due to a better ventilation–perfusion matching and/or to recruitment of dorsal lung parenchyma with a decrease in shunt fraction. Prone position is used as a rescue therapy during acute respiratory distress syndrome (ARDS) in severely hypoxic patients in whom it usually improves oxygenation and lung mechanics. In healthy pigs, prone position ameliorates lung mechanical properties and increases functional residual capacity independently from lung recruitment, through a redistribution of lung aeration. A higher amount of well-aerated and a lower amount of poorly aerated lung tissue were found in prone position. Lung recruitment was low (3 ± 2 %) and was not correlated to increases in functional residual capacity ( R 2 0.2, p = 0.19). Non-aerated (recruitable) lung tissue was a small percentage of the total lung tissue weight in both positions (4 ± 3 vs 1 ± 1 %, supine vs prone, p = 0.004). Recruitment was defined as a percentage change in non-aerated lung tissue compared to the total lung weight. functional residual capacity (FRC)) and the distribution of aeration. A lung computed tomography (CT) scan was performed in the two positions to compute gas content (i.e. Ten healthy pigs under general anaesthesia and paralysis underwent a pressure–volume curve of the respiratory system, chest wall and lung in supine and prone positions the respective elastances were measured. We hypothesised that, in the absence of recruitment, prone position would not result in any improvement in lung mechanical properties or gas content compared to supine position. Chronic Obstructive Pulmonary Disease.Prone position is used to recruit collapsed dependent lung regions during severe acute respiratory distress syndrome, improving lung elastance and lung gas content. Asthma-COPD Overlap.Ĭenters for Disease Control and Prevention. CFTR dysfunction in cystic fibrosis and chronic obstructive pulmonary disease. The burden of idiopathic pulmonary fibrosis: An unmet public health need. Lee AS, Mira-Avendano I, Ryu JH, Daniels CE. Pattern of lung function decline in patients with amyotrophic lateral sclerosis: implications for timing of noninvasive ventilation. ![]() Panchabhai TS, Mireles Cabodevila E, Pioro EP, Wang X, Han X, Aboussouan LS. The inspiratory capacity/total lung capacity ratio as a predictor of survival in an emphysematous phenotype of chronic obstructive pulmonary disease. Pulmonary function tests.įrench A, Balfe D, Mirocha J, Falk J, Mosenifar Z. Physiology, Lung Capacity.Īmerican Thoracic Society. ![]()
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