Item request has been placed! ×
Item request cannot be made. ×
loading  Processing Request

Impact of vertical positioning on lung aeration among mechanically ventilated intensive care unit patients: a randomized crossover clinical trial.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
اقرأ على الانترنت اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • المصدر:
      Publisher: Associação de Medicina Intensiva Brasileira Country of Publication: Brazil NLM ID: 9918627781706676 Publication Model: Print Cited Medium: Internet ISSN: 2965-2774 (Electronic) Linking ISSN: 29652774 NLM ISO Abbreviation: Crit Care Sci Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: São Paulo, SP, Brazil : Associação de Medicina Intensiva Brasileira, [2023]-
    • الموضوع:
      COVID-19* ; Orthostatic Intolerance*; Adult ; Humans ; Male ; Aged ; Female ; Dizziness ; Respiration, Artificial ; Critical Care ; Intensive Care Units
    • نبذة مختصرة :
      Objective: To assess the impact of different vertical positions on lung aeration in patients receiving invasive mechanical ventilation.
      Methods: An open-label randomized crossover clinical trial was conducted between January and July 2020. Adults receiving invasive mechanical ventilation for > 24 hours and < 7 days with hemodynamic, respiratory and neurological stability were randomly assigned at a 1:1 ratio to the sitting position followed by passive orthostasis condition or the passive orthostasis followed by the sitting position condition. The primary outcome was lung aeration assessed using the lung ultrasound score (score ranges from 0 [better] to 36 [worse]).
      Results: A total of 186 subjects were screened; of these subjects, 19 were enrolled (57.8% male; mean age, 73.2 years). All participants were assigned to receive at least one verticalization protocol. Passive orthostasis resulted in mean lung ultrasound scores that did not differ significantly from the sitting position (11.0 versus 13.7; mean difference, -2.7; [95%CI -6.1 to 0.71; p = 0.11). Adverse events occurred in three subjects in the passive orthostasis group and in one in the sitting position group (p = 0.99).
      Conclusion: This analysis did not find significant differences in lung aeration between the sitting and passive orthostasis groups. A randomized crossover clinical trial assessing the impact of vertical positioning on lung aeration in patients receiving invasive mechanical ventilation is feasible. Unfortunately, the study was interrupted due to the need to treat COVID-19 patients.ClinicalTrials.gov registry: NCT04176445.
    • References:
      J Biomed Inform. 2009 Apr;42(2):377-81. (PMID: 18929686)
      Crit Care Med. 1992 Mar;20(3):366-71. (PMID: 1541097)
      Clin Infect Dis. 2013 Feb;56(4):471-7. (PMID: 23118272)
      Heart Lung. 2014 Mar-Apr;43(2):105-11. (PMID: 24594247)
      Crit Care Med. 2012 Jul;40(7):2064-72. (PMID: 22584759)
      BMC Med Res Methodol. 2014 Dec 19;14:135. (PMID: 25524443)
      JAMA. 2002 Dec 11;288(22):2859-67. (PMID: 12472328)
      Ann Am Thorac Soc. 2016 May;13(5):724-30. (PMID: 27144796)
      J Intensive Care. 2019 Dec 02;7:54. (PMID: 31827802)
      Arch Phys Med Rehabil. 2004 Dec;85(12):1972-6. (PMID: 15605335)
      Aust J Physiother. 2004;50(2):95-100. (PMID: 15151493)
      Eur J Intern Med. 2012 Jul;23(5):391-7. (PMID: 22726366)
      Respir Care. 2010 Apr;55(4):400-7. (PMID: 20406506)
      NeuroRehabilitation. 2009;24(3):237-42. (PMID: 19458431)
      Respir Care. 2014 Oct;59(10):1583-9. (PMID: 24847096)
      Intensive Care Med. 2009 Jun;35(6):969-76. (PMID: 19242675)
      CJEM. 2019 May;21(3):399-405. (PMID: 30678741)
      Crit Care. 2015 Feb 26;19:81. (PMID: 25715872)
      Lancet Infect Dis. 2013 Aug;13(8):665-71. (PMID: 23622939)
      Intensive Care Med. 2014 Mar;40(3):370-9. (PMID: 24257969)
      PLoS One. 2018 Nov 14;13(11):e0207428. (PMID: 30427933)
      J Crit Care. 2015 Jun;30(3):655.e1-6. (PMID: 25622762)
      Open Access Maced J Med Sci. 2019 Apr 14;7(7):1143-1147. (PMID: 31049097)
      Intensive Care Med. 2013 Jun;39(6):1121-7. (PMID: 23344832)
      Respir Care. 2021 Feb;66(2):253-262. (PMID: 32994357)
      J Crit Care. 2018 Aug;46:37-43. (PMID: 29660670)
      PLoS One. 2019 Oct 3;14(10):e0223185. (PMID: 31581205)
      Intensive Care Med. 2006 Oct;32(10):1623-6. (PMID: 16896856)
      Crit Care Med. 2013 Nov;41(11):2592-9. (PMID: 23939358)
      Am J Hypertens. 2011 Oct;24(10):1073-9. (PMID: 21677699)
    • Molecular Sequence:
      ClinicalTrials.gov NCT04176445
    • الموضوع:
      Date Created: 20240124 Date Completed: 20240125 Latest Revision: 20240127
    • الموضوع:
      20240127
    • الرقم المعرف:
      PMC10802776
    • الرقم المعرف:
      10.5935/2965-2774.20230069-en
    • الرقم المعرف:
      38265318