Zhongguo linchuang yanjiu (Aug 2025)
Safety and efficacy of prone position ventilation in patients with severe pneumonia in neurosurgical intensive care units
Abstract
Objective To investigate the effectiveness and safety of prone position ventilation in treating critically illpatients with neurosurgical ⁃ related diseases complicated by severe pneumonia，and to provide reference for thetreatment of severe pneumonia. Methods A retrospective analysis was conducted on the clinical data of 41 patients with neurosurgical⁃related diseases and severe pneumonia admitted to the Neurosurgical Intensive Care Unit of Nanjing Drum Tower Hospital，the Affiliated Hospital of Nanjing University Medical School，from January 2023 to November 2024. All patients experienced progressive worsening of pulmonary inflammation and severe hypoxemia after conventional treatment，and were given prone position ventilation. Changes in blood gas analysis［pH，arterial partial pressure of oxygen（PaO2），arterial partial pressure of carbon dioxide（PaCO2），oxygenation index］and hemodynamics［heart rate（HR），mean arterial pressure（MAP）］were compared before prone positioning，and at 1 day，3 days，5 days，and 7 days after resuming supine position following prone position treatment. Results The average hospitalization duration in the neurosurgical intensive care unit for the 41 patients was（20.49 ± 5.14）days. The oxygenation index before prone positioning and at 1 day，3 days，5 days，and 7 days after pone positioning were（104.12±11.09）mmHg，（118.67 ± 18.58） mmHg，（148.20 ± 29.17） mmHg，（237.21 ± 56.91） mmHg，and （303.26 ± 66.78） mmHg，respectively，showing a significant upward trend （F=164.657，P0.05）. Conclusion Prone position ventilation effectively can improve the oxygenation index in critically ill neurosurgical patients with severe pneumonia. As treatment duration increases，the oxygenation index gradually improves without significant impact on hemodynamics，proving it to be both safe and effective for such patients
Keywords
