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This study evaluates the effects of prone positioning on homogenization of ventilation.
After initiation of mechanical ventilation and assessing the eligibility of the patient, informed consent will be taken from the closest kin. If eligible, following steps will be performed which are part of standard ARDS patient care.
Afterwards, phase III slope of the patient will be recorded at four timepoints:
Supine 1 (immediately before turning to prone position) Prone 1 (immediately after prone position) Prone 2 (at the end of the 16-24 hour prone cycle) Supine 2 (immediately after turning to supine position)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Baseline slope of phase iii | Severe ARDS patients who are intubated and mechanically ventilated and will undergo prone positioning |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Prone Positioning | Procedure | Patients will be turned to prone position and they will be left in prone position for a duration of at least 16 hours to a maximum of 24 hours. This duration is recommended by the ARDS guidelines. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in phase iii slope of the volumetric capnograph | phase iii slope is associated with the ventilation homogeneity | 16 to 24 hours (according to time spent in the prone position) |
| correlation of the phase iii slope with the recruitment to inflation ratio | recruitment to inflation ratio is a simple bedside tool that indicates a higher possible recruitable lung with higher applied Positive End-Expiratory Pressure | 16 to 24 hours (according to time spent in the prone position) |
| Measure | Description | Time Frame |
|---|---|---|
| correlation of the phase iii slope with the Partial pressure of the arterial oxygen/ Fraction of inspired O2 concentration (PaO2/FiO2) ratio | PaO2/FiO2 is markedly reduced in ARDS patients as a consequence of aeration loss | 16 to 24 hours (according to time spent in the prone position) |
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Inclusion Criteria:
Exclusion Criteria:
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Adult mixed critical care patients
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Olcay Dilken, MD | Contact | +905547378709 | olcaydilken@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Olcay Dilken, MD | Hamidiye Etfal Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hamidiye Etfal Hospital | Recruiting | Istanbul | 34000 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D012128 | Respiratory Distress Syndrome |
| D012131 | Respiratory Insufficiency |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
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| ID | Term |
|---|---|
| D016684 | Prone Position |
| ID | Term |
|---|---|
| D011187 | Posture |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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