Effects of prone and supine posture on cardiopulmonary function after experimental chlorine gas lung injury

J. Wang, F. M. Abu-Zidan, S. M. Walther

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Background: Chlorine gas may induce severe acute lung injury. Improvement of pulmonary gas exchange in patients and animals with acute lung injury nursed in the prone position was observed in recent years. The purpose of this study was to evaluate the effects of prone and supine positions on pulmonary and cardiovascular functions following experimental chlorine gas lung injury. Methods: Twenty anesthetized and mechanically ventilated pigs were exposed to chlorine gas (400 p.p.m. in air) for 20 min in the supine position, then assigned randomly to ventilation in the supine or prone positions (n=10 in each group). Hemodynamics, gas exchange, lung mechanics and oxygen transport were evaluated for 5h. Results: All animals showed severe pulmonary dysfunction immediately after chlorine gassing with a threefold increase in pulmonary vascular resistance index, a drop in arterial oxygenation (12.3±1.3 kPa to 5.4±0.7 kPa) and a fall in lung-thorax compliance (22±1 ml cmH2O-1 to 8±2 ml cmH2O-1). Venous admixture (Qs/Qt) improved in animals in the prone position while there was no change in the supine position (prone 32±11% vs. supine 42±9% at 5h, P<0.05). Lung-thorax compliance improved significantly with time in the prone group only (P<0.01). Oxygen delivery increased significantly in prone animals compared with animals nursed in the supine posture (P<0.001). Conclusion: Immediate prone positioning after chlorine gas injury not only inhibited deterioration of gas exchange but was also associated with improved pulmonary function and oxygen transport.

Original languageEnglish
Pages (from-to)1094-1102
Number of pages9
JournalActa Anaesthesiologica Scandinavica
Volume46
Issue number9
DOIs
Publication statusPublished - Oct 2002
Externally publishedYes

Keywords

  • Acute lung injury
  • Chlorine
  • Oxygen transport
  • Prone position
  • Severe hypoxia
  • Supine position

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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