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Table 1 Respiratory mechanics using three different PEEP titration strategies during supine and prone positioning

From: Effects of different positive end-expiratory pressure titration strategies during prone positioning in patients with acute respiratory distress syndrome: a prospective interventional study

 

PEEPARDSNetwork

PEEPEstat,RS

PEEPPtpexp

p values

Supine

Prone

Supine

Prone

Supine

Prone

Positioning effect

PEEP strategy effect

Positioning and PEEP strategy interaction

RR (breaths/min)

22.3 ± 1.9

22.3 ± 1.9

22.3 ± 1.9

22.3 ± 1.9

22.3 ± 1.9

22.3 ± 1.9

1.000

1.000

1.000

VT (mL/kg PBW)

6.2 ± 0.3

6.2 ± 0.3

6.2 ± 0.3

6.2 ± 0.3

6.2 ± 0.3

6.2 ± 0.3

1.000

1.000

1.000

Ppeak,RS (cm H2O)

23.3 ± 5.1

23.5 ± 4.5

25.0 ± 5.1

23.3 ± 4.5*

30.6 ± 8.8

27.2 ± 8.8*

< 0.001

< 0.001

< 0.001

Pmean,RS (cm H2O)

13.5 ± 2.9

13.5 ± 2.7

15.8 ± 4.0

13.6 ± 3.4*

20.5 ± 6.1

16.5 ± 6.5*

< 0.001

< 0.001

< 0.001

Pesinsp (cm H2O)

14.2 ± 3.5

11.4 ± 3.7*

14.8 ± 4.4

11.4 ± 4.6*

17.1 ± 5.7

13.0 ± 6.0*

< 0.001

< 0.001

0.007

Pesexp (cm H2O)

11.3 ± 3.1

7.7 ± 3.2*

12.1 ± 4.0

7.9 ± 4.0*

13.4 ± 5.4

9.4 ± 5.4*

< 0.001

< 0.001

0.572

∆Pes (cm H2O)

2.9 ± 1.6

3.6 ± 1.9*

2.7 ± 1.5

3.5 ± 1.9*

3.0 ± 1.8

3.5 ± 2.0*

< 0.001

0.141

0.339

Estat,RS (cm H2O/L)

21.3 ± 6.5

21.7 ± 6.0

19.5 ± 5.8

20.8 ± 5.2*

20.7 ± 8.0

22.1 ± 6.4*

0.032

0.023

0.255

Estat,CW (cm H2O/L)

7.1 ± 4.2

9.0 ± 5.0*

6.6 ± 4.2

8.6 ± 4.9*

7.3 ± 4.8

8.8 ± 5.2*

< 0.001

0.132

0.397

Estat,L (cm H2O/L)

14.0 ± 5.5

13.0 ± 5.3

12.8 ± 4.8

12.6 ± 5.4

13.4 ± 6.9

13.9 ± 6.8

0.565

0.093

0.087

Mechanical power (J/min)

17.5 ± 5.7

17.6 ± 5.5

19.2 ± 5.9

17.5 ± 5.8*

24.4 ± 9.8

21.0 ± 9.6*

< 0.001

< 0.001

< 0.001

IAP (cm H2O)

8.3 ± 2.8

11.1 ± 3.0*

8.7 ± 2.9

11.1 ± 3.5*

9.9 ± 3.5

12.1 ± 3.8*

< 0.001

< 0.001

0.238

VD/VT (%)

28.5 ± 10.9

25.2 ± 9.0*

27.6 ± 10.8

24.7 ± 9.5*

28.4 ± 10.5

25.8 ± 9.5*

< 0.001

0.224

0.739

Ventilatory rate

2.09 ± 0.5

2.11 ± 0.5

2.12 ± 0.5

2.13 ± 0.5

2.13 ± 0.5

2.14 ± 0.5

0.308

0.176

0.345

EELV (mL)

1630 ± 552

1972 ± 693*

1920 ± 556

1993 ± 627

2140 ± 615

2108 ± 736

0.011

< 0.001

< 0.001

  1. Values are means ± standard deviation of 40 patients with moderate to severe ARDS. Two-way repeated measures ANOVA was used to compare the effects of different PEEP titration strategies on respiratory mechanics during supine and prone positioning (p < 0.05)
  2. Bold numbers represent statistically significant differences between groups
  3. ∆Pes difference between esophageal pressure at plateau airway pressure and positive end-expiratory pressure, EELV end-expiratory lung volume, Estat,CW static elastance of the chest wall, Estat,L static elastance of the lung, Estat,RS static elastance of the respiratory system, IAP intraabdominal pressure, PBW predicted body weight, PEEP positive end-expiratory pressure, PEEPARDSNetwork PEEP titrated according to the ARDS Network lower PEEP table, PEEPEstat,RS PEEP titrated according to the lowest elastance of the respiratory system, PEEPPtpexp PEEP titrated according to end-expiratory transpulmonary pressure, Pesexp esophageal pressure at positive end-expiratory pressure, Pesinsp esophageal pressure at plateau airway pressure, Pmean,RS mean airway pressure of the respiratory system, Ppeak,RS peak airway pressure of the respiratory system, RR respiratory rate, VD/VT ratio of physiologic dead space to tidal volume, VT tidal volume
  4. *Significant differences at each PEEP titration strategy between supine and prone positioning
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Critical Care

ISSN: 1364-8535