Prone position in mechanically ventilated patients -- the hard or the soft way?
Prone positioning may even in patients without abdominal hypertension result in an increased intra-abdominal pressure (IAP). Previous research could not demonstrate a marked increase in IAP associated with cardiovascular, renal, or hepato-splanchnic dysfunction when patients were proned in air-cushioned beds. Michelet and colleagues in this issue of Critical Care report that the increase in IAP in the prone position depends on the used mattress type. Compared with air-cushion beds, conventional foam mattresses resulted in a greater increase in IAP which was associated with a decrease in the plasma disappearance rate of indocyanin green (PDRICG) indicating inadequate heptosplanchnic function.
Department of Anesthesiology and Intensive Care Medicine, University of Bonn, Bonn, Germany. Christian.Putensen@ukb.uni-bonn.de
Christian
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Putensen
D000818:Animals; D001513:Beds; D006801:Humans; D011312:Pressure; D003668:Pressure Ulcer / Q000517:prevention & control; D016684:Prone Position; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000628:therapy*; D013552:Swine