• Martin Matejovic, Richard Rokyta, Peter Radermacher, Ales Krouzecky, Vladimir Sramek, and Ivan Novak.
• Intensive Care Unit, 1st Medical Department, Charles University Hospital Plzen, Alej svobody 80, 304 60 Plzen, Czech Republic. matejovic@fnplzen.cz
• Intensive Care Med. 2002 Dec 1;28(12):1750-5.

ObjectiveTo evaluate the effects of prone position on hepato-splanchnic hemodynamics, metabolism and gut mucosal energy balance.DesignProspective clinical study.SettingMedical intensive care unit in a university hospital.PatientsEleven hemodynamically stable patients with acute lung injury (ALI) requiring mechanical ventilation.InterventionPatients were studied in the supine position, after 90 min in the prone position and after 90 min of supine repositioning.Measurements And ResultsIn addition to global hemodynamics we measured intra-abdominal pressure (IAP, bladder), hepato-splanchnic blood flow (HSBF, steady state indocyanine green technique using a hepatic vein catheter) and gastric mucosal-arterial PCO(2) gap (PCO(2) gap, automated air tonometry). Systemic hemodynamics did not change during the whole study. Prone positioning did not significantly affect IAP. HSBF as well as splanchnic oxygen consumption remained unaltered, too. Similarly, neither liver lactate uptake nor indocyanine green extraction were influenced by positional changes. Finally, stable regional hemodynamics were accompanied by an unchanged PCO(2) gap.ConclusionWe conclude that if IAP and systemic hemodynamics remain unaffected, the prone position in ALI patients compromises neither hepato-splanchnic perfusion nor gastric mucosal energy balance.

33 keywords...

hide…