Prone Position in Treatment of Hypoxemia in Patients Who Underwent Type A Aortic Dissection Surgery

Authors

  • Junjun Gu, BN Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
  • Yulan Feng, BN Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
  • Si Chen, BN Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
  • Yingdan Cao, BN Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
  • Kexin Li, BN Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
  • Yanze Du, BN Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
  • Ning Li Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
  • Haiyan Li, BN Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China

DOI:

https://doi.org/10.1532/hsf.4535

Keywords:

prone position, type A aortic dissection, hypoxemia

Abstract

Background: Postoperative hypoxemia is a high-risk complication after acute type A aortic dissection (TAAD) surgery. Prone position (PP) is an effective treatment for acute respiratory failure, which may improve the gas exchange of the injured lung and the patient’s survival. PP is reported to improve the respiratory condition after cardiac surgery. However, limited data exist on the effect of PP in patients who underwent acute TAAD surgery.

Methods: We retrospectively analyzed the clinical outcomes of seven patients with severe hypoxemia who underwent PP after acute TAAD surgery. The results of arterial blood gas, chest X-ray, and survival were collected.

Results: Seven patients (3 female, mean age 48.3±11.7 years) were recruited in this study. All patients received total arch replacement and frozen elephant trunk implantation procedure. The PaO2 at day 1 after PP was higher than before PP (126.3±49.3 vs. 77.8±15.5 mmHg). The oxygenation index rose sharply from 83.0 (80.0, 87.0) to 188.3±56.5 at day 3 after PP. There was no significant difference in heart rate between before and after PP procedure. Chest X-ray showed the diffuse shadow was significantly improved after PP. All patients responded well to PP, and all patients were discharged except for one patient, who died perioperatively due to multiple organ failure.

Conclusions: PP is a safe and feasible option for severe hypoxemia patients after TAAD surgery.

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Published

2022-04-22

How to Cite

gu, junjunn, feng, yulan, chen, si, cao, yingdan, li, kexin, du, yanze, li, ning, & li, haiyan. (2022). Prone Position in Treatment of Hypoxemia in Patients Who Underwent Type A Aortic Dissection Surgery. The Heart Surgery Forum, 25(2), E300-E304. https://doi.org/10.1532/hsf.4535

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Articles