LEGIONELLA PNEUMONIA INDUCED ACUTE RESPIRATORY DISTRESS SYNDROME: CASE SERIES OF A TERTIARY MEDICAL CENTER IN TAIWAN

Background Manual prone positioning has been shown to reduce mortality among patients with moderate to severe acute respiratory distress syndrome, but it is associated with a high incidence of pressure injuries and unplanned extubations. This study investigated the feasibility of safely implementing a manual prone positioning protocol that uses a dedicated device. Review of Evidence A search of CINAHL and Medline identified multiple randomized controlled trials and meta-analyses that demonstrated both the reduction of mortality when prone positioning is used for more than 12 hours per day in patients with acute respiratory distress syndrome and the most common complications of this treatment. Implementation An existing safe patient-handling device was modified to enable staff to safely perform manual prone positioning with few complications for patients receiving mechanical ventilation. All staff received training on the protocol and use of the device before implementation. Evaluation This study included 36 consecutive patients who were admitted to the medical intensive care unit at a large academic medical center because of hypoxemic respiratory failure/acute respiratory distress syndrome and received mechanical ventilation and prone positioning. Data were collected on clinical presentation, interventions, and complications. Sustainability Using the robust protocol and the low-cost device, staff can safely perform a low-volume, high-risk maneuver. This method provides cost savings compared with other prone positioning methods. Conclusions Implementing a prone positioning protocol with a dedicated device is feasible, with fewer complications and lower costs than anticipated.

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Immediate Effects of Acapella® on Dynamic Lung Compliance in Mechanically Ventilated Patients with Acute Respiratory Distress Syndrome: A Case Series

Indian Journal of Critical Care Medicine ◽

10.4103/ijccm.ijccm_157_17 ◽

2018 ◽

Vol 22 (2) ◽

pp. 100-102

Author(s):

Priya Sharma ◽

V Prem ◽

Sakshee Jain

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Case Series ◽

Lung Compliance ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Dynamic Lung Compliance ◽

Ventilated Patients

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Prone ventilation in H1N1 virus-associated severe acute respiratory distress syndrome: A case series

International Journal of Critical Illness and Injury Science ◽

10.4103/ijciis.ijciis_62_18 ◽

2019 ◽

Vol 9 (4) ◽

pp. 182

Author(s):

JyotiNarayan Sahoo ◽

Mohan Gurjar ◽

Krantimaya Mohanty ◽

Kalpana Majhi ◽

G Sradhanjali

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

H1n1 Virus ◽

Case Series

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Use of cidofovir with extracorporeal membrane oxygenation to treat adenovirus‐associated acute respiratory distress syndrome in paediatric patients— a case series

Journal of Clinical Pharmacy and Therapeutics ◽

10.1111/jcpt.13244 ◽

2020 ◽

Vol 45 (6) ◽

pp. 1505-1510

Author(s):

Thao K. Le ◽

Brian K. Brown ◽

Katie C. Namtu ◽

David M. Berman ◽

Amy L. Kiskaddon

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Extracorporeal Membrane Oxygenation ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Case Series ◽

Membrane Oxygenation ◽

Paediatric Patients

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The Use of a Kinetic Therapy Rotational Bed in Pediatric Acute Respiratory Distress Syndrome: A Case Series

Children ◽

10.3390/children7120303 ◽

2020 ◽

Vol 7 (12) ◽

pp. 303

Author(s):

Daniel T. Cater ◽

Aimee R. Ealy ◽

Erin Kramer ◽

Samer Abu-Sultaneh ◽

Courtney M. Rowan

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Case Series ◽

Published Data ◽

Arterial Line ◽

Prone Positioning ◽

Retrospective Case ◽

Oxygenation Indices

Patients with acute respiratory distress syndrome (ARDS) commonly have dependent atelectasis and heterogeneous lung disease. Due to the heterogenous lung volumes seen, the application of positive end expiratory pressure (PEEP) can have both beneficial and deleterious effects. Alternating supine and prone positioning may be beneficial in ARDS by providing more homogenous distribution of PEEP and decreasing intrapulmonary shunt. In pediatrics, the pediatric acute lung injury and consensus conference (PALICC) recommended to consider it in severe pediatric ARDS (PARDS). Manually prone positioning patients can be burdensome in larger patients. In adults, the use of rotational beds has eased care of these patients. There is little published data about rotational bed therapy in children. Therefore, we sought to describe the use of a rotational bed in children with PARDS. We performed a retrospective case series of children who utilized a rotational bed as an adjunctive therapy for their PARDS. Patient data were collected and analyzed. Descriptive statistical analyses were performed and reported. Oxygenation indices (OI) pre- and post-prone positioning were analyzed. Twelve patients with PARDS were treated with a rotational bed with minimal adverse events. There were no complications noted. Three patients had malfunctioning of their arterial line while on the rotational bed. Oxygenation indices improved over time in 11 of the 12 patients included in the study while on the rotational bed. Rotational beds can be safely utilized in pediatric patients. In larger children with PARDS, where it may be more difficult to perform a manual prone position, use of a rotational bed can be considered a safe alternative.

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