Successful use of an automated proning system to achieve prone positioning in a patient with severe ARDS requiring veno-venous ECMO.

Andrew L Lehr, Deane E Smith, Bridget Toy, Ronald Goldenberg, Shari B Brosnahan

Abstract readCase Reports

In one paragraph

Article in Respiratory medicine case reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Andrew L LehrDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University Langone Health, New York, NY, USA.

Deane E SmithDepartment of Cardiothoracic Surgery, New York University Langone Health, New York, NY, USA.

Bridget ToyTransplant Institute, New York University Langone Health, New York, NY, USA.

Ronald GoldenbergDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University Langone Health, New York, NY, USA.

Shari B BrosnahanDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University Langone Health, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A morbidly obese middle aged woman in her 40's presented to another hospital with methicillin resistant staphylococcus aureus pneumonia and subsequently developed severe acute respiratory distress syndrome. Her oxygenation demonstrated no improvement with low tidal volume ventilation, paralysis, or prostagladin therapy. She was unable to be manually proned secondary to her habitus. She was subsequently transferred to our facility, where she was initiated on VV-ECMO. Maximal flow through the ECMO circuit was inadequate for oxygenation given significant systemic shunt through her native lungs. In order to optimize lung protective ventilation and treat ARDS, we used an automated kinetic system (Rotoprone Therapy System) to prone the patient. To our knowledge, this is the first description in the literature of using an automated proning system with an ECMO circuit in place. This report describes the technique we used to safely perform axial rotations for two days with fewer providers required than manual proning.

Indexed as

Acute respiratory distress syndromeExtracorporeal membrane oxygenationProne positioning

Identifiers

PMID33335831

DOI10.1016/j.rmcr.2020.101315

PMCPMC7734294

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LicenceCC BY-NC-ND

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.