Clinical application of the new prone position turning assistance device in patients with acute respiratory distress syndrome

doi:10.3877/cma.j.issn.1674-6902.2025.05.017

Abstract

Abstract:

Objective

To analyze the clinical efficacy of a novel prone positioning assistive device in patients with acute respiratory distress syndrome (ARDS), aiming to reduce the number of healthcare workers required for traditional manual positioning, decrease complication risks, and address clinical workforce shortages.

Methods

Twenty-nine ARDS patients (severe cases 10.34%) admitted between April 2021 and July 2022 and meeting the Berlin Definition criteria were enrolled. A total of 58 prone positioning sessions were performed, using a self-controlled design, 29 manual turns, 29 device-assisted turns. The assistive device comprised a body-turning blanket and a lifting mechanism to secure and mechanically reposition patients. Manual turns required 4~5 staff members. Operation times (preparation time T₁, turning time T₂), complications, and workload index (staff number×time) were recorded.

Results

Device-assisted turns required(3.34±0.48) staff members, significantly fewer than manual turns (5.10±0.49)(P<0.05).Workload index was lower in the device-assisted group (1 397.00±341.67) s versus the manual group (1 932.00±365.76) s(P<0.05). Total operation time (TT=T₁+ T₂) was longer for device-assisted turns (P<0.05), primarily due to increased T₁(blanket placement). No difference was observed in T₂. Complication rates 6.90% were identical, Manual group: 1 hypoxemia + 1 gastric tube dislodgement. Device-assisted group: 1 pressure ulcer + 1 gastric tube dislodgement (P>0.05). Vital signs, blood gas parameters and ventilator settings showed no significant differences between groups.

Conclusion

The novel prone positioning assistive device significantly reduces healthcare worker requirements and overall workload without increasing complication risks. It offers a safe and efficient solution for promoting prone ventilation therapy in ICU settings facing workforce shortages.

Key words: Acute respiratory distress syndrome, Prone ventilation, Assisted turns, Clinical application

Yuqing Lu, Dawei Li, Jianfeng Zou, Zilong Hu, Zhe Li, Qi Li, Liyuan Zhang, Meng Huo, Yue Shen, Weizheng Shuai. Clinical application of the new prone position turning assistance device in patients with acute respiratory distress syndrome[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(05): 757-761.

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Figures/Tables 4

References 25

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临床资料	构成比
年龄[岁，M(Q₂₅，Q₇₅)]	65(54，69)
身高[cm, M(Q₂₅，Q₇₅)]	175(167，178)
体质量[kg, M(Q₂₅，Q₇₅)]	71(64，81)
BMI[kg/m², M(Q₂₅，Q₇₅)]	23.67(22.21，26.56)
APACHE Ⅱ[分，M(Q₂₅，Q₇₅)]	28(22，34)
SOFA[分，M(Q₂₅，Q₇₅)]	9(6，13)
主要诊断[n(%)]
肺炎	3(10.34)
冠心病	4(13.79)
脓毒症	5(17.24)
脑血管疾病	12(41.37)
肠梗阻	3(10.34)
基础疾病[n(%)]
高血压	16(55.17)
高胆固醇血症	11(37.93)
糖尿病	12(41.38)
心脏疾病	5(17.24)
心房颤动	6(20.69)
恶性肿瘤	6(20.69)

临床资料	构成比
年龄[岁，M(Q₂₅，Q₇₅)]	65(54，69)
身高[cm, M(Q₂₅，Q₇₅)]	175(167，178)
体质量[kg, M(Q₂₅，Q₇₅)]	71(64，81)
BMI[kg/m², M(Q₂₅，Q₇₅)]	23.67(22.21，26.56)
APACHE Ⅱ[分，M(Q₂₅，Q₇₅)]	28(22，34)
SOFA[分，M(Q₂₅，Q₇₅)]	9(6，13)
主要诊断[n(%)]
肺炎	3(10.34)
冠心病	4(13.79)
脓毒症	5(17.24)
脑血管疾病	12(41.37)
肠梗阻	3(10.34)
基础疾病[n(%)]
高血压	16(55.17)
高胆固醇血症	11(37.93)
糖尿病	12(41.38)
心脏疾病	5(17.24)
心房颤动	6(20.69)
恶性肿瘤	6(20.69)

临床指标	人力翻身	辅助翻身	P值
FiO₂(%)	40(35，45)	40(35，45)	0.482
VT(ml)	411(326，435)	386(346，430)	0.690
PEEP(cmH₂O)	5(3，8)	5(3，8)	0.727
P-PEAK(cmH₂O)	17(16，23)	17(17，22)	0.661
PaO₂(mmHg)	103(92，125)	108(84，120)	0.954
PaCO₂(mmHg)	37(33，39)	35(32，39)	0.276
P/F(mmHg)	272(240，307)	276(240，308)	0.085
SaO₂(%)	99(96，99.5)	99(98，100)	0.296
Lac(mmol/L)	1.3(1.1，2)	1.4(1.2，1.6)	0.579
HR(bpm)	88(80，108)	90(77，98)	0.386
SBP(mmHg)	133(122，149)	125(114，135)	0.310
DBP(mmHg)	65(59，76)	63(60，74)	0.721
MAP(mmHg)	88(78，97)	82(78，95)	0.240

临床指标	人力翻身	辅助翻身	P值
FiO₂(%)	40(35，45)	40(35，45)	0.482
VT(ml)	411(326，435)	386(346，430)	0.690
PEEP(cmH₂O)	5(3，8)	5(3，8)	0.727
P-PEAK(cmH₂O)	17(16，23)	17(17，22)	0.661
PaO₂(mmHg)	103(92，125)	108(84，120)	0.954
PaCO₂(mmHg)	37(33，39)	35(32，39)	0.276
P/F(mmHg)	272(240，307)	276(240，308)	0.085
SaO₂(%)	99(96，99.5)	99(98，100)	0.296
Lac(mmol/L)	1.3(1.1，2)	1.4(1.2，1.6)	0.579
HR(bpm)	88(80，108)	90(77，98)	0.386
SBP(mmHg)	133(122，149)	125(114，135)	0.310
DBP(mmHg)	65(59，76)	63(60，74)	0.721
MAP(mmHg)	88(78，97)	82(78，95)	0.240

并发症	人力翻身	辅助翻身
呼吸系统
低氧血症	1(3.45)	0
循环系统	0	0
皮肤损坏
压疮	0	1(3.45)
导管相关
胃管脱落	1(3.45)	1(3.45)
合计	2(6.90)	2(6.90)

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