title: Long-term outcomes in survivors of acute respiratory distress syndrome ventilated in supine or prone position.
abstract: OBJECTIVE
  The aim of this study is to examine long-term pulmonary function and quality of life in survivors of acute respiratory distress syndrome (ARDS) previously enrolled in a randomized multicenter trial testing prone compared with supine positioning (PSII study) at five Italian centers.
  
  
  METHODS
  Observational prospective study.
  
  
  METHODS
  Pulmonary function [spirometric test, gas exchange, carbon monoxide diffusion capacity (DLCO)], high-resolution computed tomography (CT) scan, and health-related quality of life [Short Form-36 (SF-36) and St. George's Respiratory Questionnaire] were evaluated at 12 months.
  
  
  RESULTS
  Twenty-six patients (13 in each group, mean age 54.1 ± 2.8 years, body mass index 24.5 ± 1.4 kg/m(2), PaO(2)/FiO(2) 117 ± 49 mmHg) were evaluated. There were no significant differences in demographic data, illness severity, or outcome between the prone and supine groups. The overall survival rate was 40%. Pulmonary function was in the normal range without any differences between the two groups. Quantitative lung CT scan analysis showed similar amounts for not aerated (8.1 ± 3.2% versus 7.3 ± 3.4%), poorly aerated (15.3 ± 3.6% versus 17.1 ± 4.9%), and well-aerated (64.0% ± 8.4 versus 70.2 ± 8.4%) lung regions, while overaerated lung region was slightly higher in the prone compared with the supine group (12.5 ± 6.5% versus 5.3 ± 5.5%). Health-related quality of life was similar to in healthy population. However, these patients showed reduction in daily activity specifically due to pulmonary disease as measured by the St. George's Respiratory Questionnaire.
  
  
  CONCLUSIONS
  No differences in pulmonary function or quality of life were observed in this small group of ARDS survivor patients treated in prone versus supine position.
authors.affiliation: Dipartimento di Anestesia, Rianimazione (Intensiva e Subintensiva) e Terapia del Dolore, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy. chiumello@libero.it
authors.forename: D
authors.initials: D
authors.lastname: Chiumello
authors.forename: P
authors.initials: P
authors.lastname: Taccone
authors.forename: V
authors.initials: V
authors.lastname: Berto
authors.forename: A
authors.initials: A
authors.lastname: Marino
authors.forename: G
authors.initials: G
authors.lastname: Migliara
authors.forename: M
authors.initials: M
authors.lastname: Lazzerini
authors.forename: L
authors.initials: L
authors.lastname: Gattinoni
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000379:methods*; D016684:Prone Position; D011446:Prospective Studies; D011788:Quality of Life; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D016037:Single-Blind Method; D016683:Supine Position; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome