[Kinetic therapy for acute respiratory distress syndrome].
The authors evaluated the clinical and physiological effects of kinetic therapy (KT) in the treatment of acute respiratory distress syndrome (ARDS). Forty-six patients with ARDS underwent successive postural positioning in accordance with two regimens: 1) lateral, prone, contralateral, supine positions; 2) prone, lateral, contralateral, supine positions. The criterion for changing each position was the change in monitoring indices: SpO2, PaO2, and thoracopulmonary compliance (C). KT was performed until a respirator was withdrawn from the patient. In 25 patients, each maneuver of positioning was made during 30-minute propofol sedation. The control group included 24 patients with ARDS who received neither KT nor propofol sedation. KT caused a decrease in Vd/Vt, Qs/Qt and an increase in PaO2/FiO2 and C was more intensive, as compared with the control group. The duration of the patient's prone position was 3.2-0.7 hours and that of the supine position was 3.4-0.8 hours. The right and left lateral positions lasted 1.1-0.2 and 1.3-0.2 hours, respectively. KT regimen 1 was found to be more effective than KT regimen 2. Propofol sedation enhanced the efficiency of KT. The latter reduced death rates in patients with ARDS.
Chechenin
M G
MG
Voevodin
S V
SV
Pronichev
E Iu
EIu
Shuliveĭstrov
Iu V
IuV
D000328:Adult; D003131:Combined Modality Therapy; D026241:Exercise Movement Techniques; D005260:Female; D006801:Humans; D008297:Male; D016684:Prone Position; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000628:therapy*; D016683:Supine Position; D016896:Treatment Outcome