title: Can lung ultrasonography predict prone positioning response in acute respiratory distress syndrome patients?
abstract: OBJECTIVE
  The purpose was to assess whether lung ultrasonography (L-US) is a useful tool in prediction of prone positioning (PP) oxygenation response in patients with acute respiratory distress syndrome (ARDS).
  
  
  METHODS
  In a prospective study, 19 ARDS patients were included for assessment of PP oxygenation response. The latter was assessed for at least 12 hours 6 different ultrasonography windows were performed on each hemithorax before prone (H0, H2, H12 before return to supine and at H14 (2 hours after return to supine). Patients were classified into 2 groups (responders / non responders) according their oxygenation response to PP. Ultrasonography videos were blindly evaluated by 3 expert clinicians to classify lung regions as "normal", "moderate loss of aeration," "severe loss of aeration," or "lung consolidation." Oxygenation parameters were collected at H0, H2, and H14.
  
  
  RESULTS
  Association of each lung region aspect to PP oxygenation response was compared between the 2 groups. The normal aspect of the anterobasal regions was significantly associated with the oxygenation response (P = .0436), with a positive predictive value equal to or near 100%.
  
  
  CONCLUSIONS
  Our results demonstrated that a simple and short L-US examination could be a useful tool in prediction of PP oxygenation response in ARDS patients. A normal L-US pattern of both anterobasal lung regions in supine position may predict a significant PaO2/FIO2 ratio improvement.
authors.affiliation: Réanimation Médicale, CHRU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France. Electronic address: gwenael.prat@chu-brest.fr.
authors.forename: Gwenaël
authors.initials: G
authors.lastname: Prat
authors.affiliation: Réanimation Médicale, CHRU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France. Electronic address: soleneguinard@yahoo.fr.
authors.forename: Solène
authors.initials: S
authors.lastname: Guinard
authors.affiliation: Réanimation Médicale, CHRU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France. Electronic address: biziennico@gmail.com.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bizien
authors.affiliation: UBO, CIC INSERM 1412, CHRU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France. Electronic address: emmanuel.nowak@chu-brest.fr.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Nowak
authors.affiliation: Réanimation Médicale, CHRU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France. Electronic address: jean-marie.tonnelier@chu-brest.fr.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Tonnelier
authors.affiliation: UBO, CIC INSERM 1412, CHRU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France. Electronic address: zarrin.alavi@chu-brest.fr.
authors.forename: Zarrin
authors.initials: Z
authors.lastname: Alavi
authors.affiliation: Réanimation Médicale, CHRU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France. Electronic address: anne.renault@chu-brest.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Renault
authors.affiliation: Réanimation Médicale, CHRU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France. Electronic address: jean-michel.boles@chu-brest.fr.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Boles
authors.affiliation: Réanimation Médicale, CHRU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France; LATIM INSERM UMR1101, CHRU de Brest, Université de Bretagne Occidentale, 29200 Brest, France. Electronic address: erwan.lher@chu-brest.fr.
authors.forename: Erwan
authors.initials: E
authors.lastname: L'Her
mesh_terms: D000328:Adult; D005260:Female; D006491:Hemothorax / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000379:methods*; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D016684:Prone Position; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy
keywords: Acute respiratory distress syndrome; Lung ultrasonography; Prone positioning