Objective To investigate the effects of prone position ventilation on oxygenation,hemodynamics and airway drainage in patients with severe aspiration pneumonia with acute respiratory distress syndrome (ARDS). Methods 28 patients with severe aspiration pneumonia with ARDS admitted between January 2010 and June 2012 were recruited in the study. They were ventilated in prone position with sedation and paralysis. Mean blood pressure (MAP),heart rate (HR),central venous pressure (CVP),pulse oxygen saturation (SpO₂),arterial oxygen tension (PaO₂),carbon dioxide partial pressure (PaCO₂),oxygenation index (PaO₂/FiO₂) and sputum drainage were recorded in the time points of initial supine position,prone position 1h,prone position 2h,and return to supine position 2h. Results Compared with the time point of initial supine position,PaO₂ and PaO₂/FiO₂ increased significantly after 1 and 2 hours in prone position [PaO₂:(85±12)mm Hg and (97±10)mm Hg vs. (65±11)mm Hg;PaO₂/FiO₂:(150±37)mm Hg and (158±50)mm Hg vs. (130±28)mm Hg;all P<0.05]. The effects of oxygenation improving were persistent 2h after return to supine position [PaO₂:(87±11)mm Hg;PaO₂/FiO₂:(150±52)mm Hg,P<0.05]. There was no significant difference in MAP,HR,CVP,or SpO₂ during the study. Airway sputum drainage was significantly increased 2h after in prone position compared with that in initial supine position [(15.3±2.0)mL vs. (8.1±1.1)mL,P<0.05]. Airway sputum drainage had no significant difference among 1h afer prone position,2h after return to supine position and the initial supine position [(9.1±1.0)mL and (8.3±1.2) mL vs. (8.1±1.1)mL,P>0.05]. Conclusion Prone position ventilation can improve the oxygenation in patients with severe aspiration pneumonia with ARDS,and the effects of oxygenation improvement can be persistent till 2h after return to supine position. Prone position ventilation can improve sputum drainage without significant influence on hemodynamics,thus can be used as an adjuvant treatment for severe aspiration pneumonia with ARDS. The duration of prone position ventilation needs to be prolonged for patients with much airway secretion.

Citation： HanBingzhi, HanTao, WuZhifeng. Effects of Prone Position Ventilation on Oxygenation,Hemodynamics and Airway Drainage in Patients with Severe Aspiration Pneumonia with ARDS. Chinese Journal of Respiratory and Critical Care Medicine, 2014, 13(1): 78-81. doi: 10.7507/1671-6205.2014018 Copy