Background: Prone positioning may provide a uniform distribution of transpulmonary pressure and contribute to prevent ventilator-induced lung injury. However, despite moderate positive end-expiratory pressure and low tidal volumes, there is still a risk of regional overdistension. Case presentation: A man with refractory hypoxemia was mechanically ventilated with prone positioning. Although prone positioning with a plateau pressure of 18 cmH2O and a positive end-expiratory pressure of 8 cmH2O promptly improved oxygenation, regional ventilation monitoring using electrical impedance tomography initially detected decreased distribution in the dorsal region but increased in the ventral, suggesting overdistension. Conclusions: Our experience indicates monitoring regional ventilation distribution is useful for decreasing the risk of overdistension during prone positioning.
CITATION STYLE
Kotani, T., Hanaoka, M., Hirahara, S., Yamanaka, H., Teschner, E., & Shono, A. (2018). Regional overdistension during prone positioning in a patient with acute respiratory failure who was ventilated with a low tidal volume: A case report. Journal of Intensive Care, 6(1). https://doi.org/10.1186/s40560-018-0290-z
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