Evaluation of density area in dorsal lung region during prone position using transesophageal echocardiography.
OBJECTIVE
To evaluate the changes of density area in the dorsal lung regions of acute respiratory distress syndrome patients during prone position using transesophageal echocardiography.


METHODS
Retrospective clinical study.


METHODS
General intensive care unit in a university hospital.


METHODS
Ten patients with acute respiratory distress syndrome who underwent prone position therapy.


METHODS
Density areas in the left dorsal lung region were observed using transesophageal echocardiography before and after patients were in the prone position for 2 hrs. In five patients, a pediatric transesophageal echocardiography probe was left in the esophagus and used for observation during the prone procedure.


RESULTS
Changes of density area and PaO2/FiO2 were observed. The density areas decreased after prone position compared with those of preprone position (preprone 11.4 +/- 5.1 cm2, after prone 5.6 +/- 3.5 cm2, mean +/- sd, p <.01, respectively). There was also a significant correlation between the percentage change of density area and PaO2/FiO2 (r =.47, p <.05) after prone position. During prone position, the density area decreased; however, there was no correlation between the percent changes of density area and PaO2/FiO2.


CONCLUSIONS
It was possible to observe the change in density area during prone position using transesophageal echocardiography. The change of density area estimated with transesophageal echocardiography during prone position was useful to estimate the effectiveness of the procedure.
Tsubo
Toshihito
T
Intensive Care Unit, University of Hirosaki School of Medicine, Aomori-ken, Japan.
Yatsu
Yuichi
Y
Tanabe
Takeshi
T
Okawa
Hirobumi
H
Ishihara
Hironori
H
Matsuki
Akitomo
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016022:Case-Control Studies; D003422:Critical Care / Q000379:methods; D016638:Critical Illness; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011336:Probability; D016684:Prone Position; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity