Case Report

Prone Ventilation in a United States Marine with Acute Respiratory Distress Syndrome and an Open Abdominal Injury

Authors: Melanie Guerrero MD, Francis Cannizzo MD, Edward Falta MD, George Berndt MD

Abstract

Abstract:A United States Marine with an open abdominal injury from a single gunshot wound to the chest and abdomen was placed in the prone position after suffering from acute respiratory distress syndrome (ARDS). Prone ventilation in traumatic injuries involving an open abdomen has been rarely reported or attempted because of the potentially fatal complication of bowel dehiscence. Improvement of gas exchange in patients with ARDS has been shown to occur with prone ventilation when conventional modes of ventilation have failed. The patient benefited from a sustained improvement in oxygenation hours after return to the supine position allowing for his rapid transport to a higher echelon of care and definitive management.

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References

References1. Salim A, Martin M, Constantinou C, et al. Acute respiratory distress syndrome in the trauma intensive care unit: morbid but not mortal. Arch Surg 2006;141:655–658.SalimA]]MartinM]]ConstantinouC&etal;Acute respiratory distress syndrome in the trauma intensive care unit: morbid but not mortal.Arch Surg2006141655-6582. Davis JW, Lemaster DM, Moore EC, et al. Prone ventilation in trauma or surgical patients with acute lung injury and adult respiratory distress syndrome: is it beneficial? J Trauma 2007;62:1201–1206.DavisJW]]LemasterDM]]MooreEC&etal;Prone ventilation in trauma or surgical patients with acute lung injury and adult respiratory distress syndrome: is it beneficial?J Trauma2007621201-12063. Jolliet P, Bulpa P, Chevrolet JC. Effects of the prone position on gas exchange and hemodynamics in severe acute respiratory distress syndrome. Crit Care Med 1998;26:1977–1985.JollietP]]BulpaP]]ChevroletJCEffects of the prone position on gas exchange and hemodynamics in severe acute respiratory distress syndrome.Crit Care Med1998261977-19854. D’Ignazio N, Iannuzzi M, Colella V, et al. Postraumatic ARDS: how to place patients who may offer technical problems in a prone position. Minerva Anestesiol 2007;73:467–470.D’IgnazioN]]IannuzziM]]ColellaV&etal;Postraumatic ARDS: how to place patients who may offer technical problems in a prone position.Minerva Anestesiol200773467-4705. Voggenreiter G, Aufmkolk M, Stiletto RJ, et al. Prone positioning improves oxygenation in post-traumatic lung injury—a prospective randomized trial. J Trauma 2005;59:333–341.VoggenreiterG]]AufmkolkM]]StilettoRJ&etal;Prone positioning improves oxygenation in post-traumatic lung injury—a prospective randomized trial.J Trauma200559333-341