Prone Positioning to Treat Acute Severe Pulmonary Edema in the Post-Cardiac Surgical Patient: A Case Report

Authors

  • Pavan Atluri
  • Patrick J. Neligan
  • Michael A. Acker
  • Dean L. Bensall
  • Jiri Horak

DOI:

https://doi.org/10.1532/HSF98.20061011

Abstract

Noncardiogenic pulmonary edema can be fatal without adequate resuscitation. We report, for the first time, the use of prone positioning in the immediate post-cardiac surgical period to treat a patient with profound hypoxemia secondary to massive (noncardiogenic) pulmonary edema. Prone positioning corrects ventilation-perfusion mismatch and allows gravity-dependent drainage of capillary leak-mediated endobronchial pulmonary fluid.

References

Albert RK, Hubmayr RD. 2000. The prone position eliminates compression of the lungs by the heart. Am J Respir Crit Care Med 161:1660-5.nFletcher SJ, Atkinson JD. 2003. Use of prone ventilation in neurogenic pulmonary oedema. Br J Anaesth 90:238-40.nGainnier M, Michelet P, Thirion X, Arnal JM, Sainty JM, Papazian L. 2003. Prone position and positive end-expiratory pressure in acute respiratory distress syndrome. Crit Care Med 31:2719-26.nGattinoni L, Pelosi P, Suter PM, Pedoto A, Vercesi P, Lissoni A. 1998. Acute respiratory distress syndrome caused by pulmonary and extrapulmonary disease. Different syndromes? Am J Respir Crit Care Med 158:3-11.nKimmel SE, Sekeres MA, Berlin JA, Goldberg LR, Strom BL. 1998. Adverse events after protamine administration in patients undergoing cardiopulmonary bypass: risks and predictors of under-reporting. J Clin Epidemiol 51:1-10.nMartynowicz MA, Walters BJ, Hubmayr RD. 2001. Mechanisms of recruitment in oleic acid-injured lungs. J Appl Physiol 90:1744-53.nNakos G, Tsangaris I, Kostanti E, et al. 2000. Effect of the prone position on patients with hydrostatic pulmonary edema compared with patients with acute respiratory distress syndrome and pulmonary fibrosis. Am J Respir Crit Care Med 161:360-8.nPuybasset L, Cluzel P, Chao N, Slutsky AS, Coriat P, Rouby JJ. 1998. A computed tomography scan assessment of regional lung volume in acute lung injury. The CT Scan ARDS Study Group. Am J Respir Crit Care Med 158:1644-55.n

Published

2006-07-14

How to Cite

Atluri, P., Neligan, P. J., Acker, M. A., Bensall, D. L., & Horak, J. (2006). Prone Positioning to Treat Acute Severe Pulmonary Edema in the Post-Cardiac Surgical Patient: A Case Report. The Heart Surgery Forum, 9(5), E762-E764. https://doi.org/10.1532/HSF98.20061011

Issue

Section

Articles