Abstract
Method: Prone position (PP) has been demonstrated to improve survival in moderate to severe acute respiratory distress syndrome (ARDS). However, the effect of PP on survival is difficult to be predicted. The objective of the study was to conduct a scoring system to predict outcomes in patients with severe ARDS received PP therapy.
Methods: A retrospective chohort analysis conducted from January 2015 to Jun 2018. We enrolled patients with acute respiratory failure and with PaO2/FiO2 ratio (PFR) less than 150 mmHg treated with PP more than 6 hours in intensive care units (ICU). Univariate and multivariate Cox regression models was used to determine independent predictors of ICU mortality.
Results: We enrolled 119 subjects received PP in ICU and the mortality rate was 56.3%. Poor prognostic factors of PP therapy was associated with aged (OR=1.04; 95% CI: 1.01-1.07), increased APACHE II score (OR=1.07; 95% CI: 1.01-1.14), Non-influenza related pulmonary ARDS (OR=3.92; 95% CI: 1.11-13.79), receiving renal replacement thearpy RRT (OR=3.17; 95% CI: 1.49-6.76), and with malignancy (OR=6.95; 95% CI: 1.94-24.94). The "prone score" has 5 parameters included age ≥ 65, receiving RRT, non-influenza pulmonary ARDS, malignancy and APACHE II score ≥ 25.The corresponding mortality rates for low risk (score 0-1), median risk (score 2-3), and high risk (score 4-5) were 13.6%, 53.3%-61.8%, and 81.8% in respectively.
Conclusion: For high risk group of PP Non-responder, alternative therapy such as Extra-Corporeal Membrane Oxygenation (ECMO) and palliative care should be considered according to the clinical judgement.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 3436.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020