Effects Of Prone Position Ventilation On Oxygenation In Early Severe Pneumonia Related AEDS

Objective:To research the effects of prone position ventilation on oxygenation in early severe pneumonia related ARDS.Method:20 patients with severe pneumonia related ARDS were selected from November 2016 to February 2018 as the research objects,the prone position ventilation was performed immediately after hospitalization,the fraction of inspiration O₂,arterial blood gas analysis indexes,heart rate,mean arterial pressure as well as the chest imagings were observed and recorded in both the supine position and the prone position,the extra-vascular lung water index and cardiac index were also recorded in patients who accepted pulse-induced contour cardiac output,in addition we also fllowed-up the 28 days fatality rate.Results:There were no significant differences at prone position 1h and prone position 2h in oxygenation compared with the supine position before prone position?P>0.05?,but at prone position 4h,prone position 8h,supine position 1h,the Pa O₂/FiO₂were significant higher than the supine position before prone position?P<0.05?.There were no significant changes in hydrogen?pH?,arterial carbon dioxide partial pressure?PaCO₂?,heart rate?HR?,and mean arterial pressure?MAP?in various periods?P>0.05?.Besides,there were8 patients who agreed to accept pulse-induced contour cardiac output?PICCO?technology,no significant difference was found in extra-vascular lung water index?EVWI?and cardiac index?CI?before and after prone position?P>0.05?,but the higher the EVWI,the lower the oxygenation index,and the severity of the disease increased.The chest imagings of severe pneumonia related ARDS were mainly characterized by the coexistence of pulmonary consolidation and ground-glass shadow,the 28 days fatality rate was 40%.Conclusions:PPV could be used to improve the oxygenation of early severe pneumonia related ARDS,the improvement was not immediately apparent,but relatively late,without obvious increase in the cardiac work and adverse influence on the hemodynamic of the patients.