Prone Positioning in ARDS: Predicting Neurological Complications via Cerebral Hemodynamics
Age≥18 years
Meet the diagnostic criteria for ARDS(Acute Respiratory Distress Syndrome),with PaO₂/FiO₂<150 mmHg,and requiring prone ventilation
Expected duration of mechanical ventilation>48 hours
Written informed consent obtained
Presence of contraindications to prone positioning(e.g.,head and neck injuries,spinal instability,severe intracranial hypertension)
Severe neurological diseases(e.g.,cerebral hemorrhage,cerebral infarction,intracranial space-occupying lesions)that may affect the monitoring of cerebral hemodynamics
Life-threatening ARDS
Patients who are unable to undergo neurological assessment
Patients with Moderate to Severe ARDS Expected to Undergo Mechanical Ventilation for Over 48 Hours
Other
Prospective
Prone ventilation
BehavioralCerebral Blood Flow Monitoring Before and After Prone Ventilation in Patients with ARDS.Cerebral blood flow,intracranial pressure,and systemic hemodynamic monitoring were performed at the following time points:before prone positioning(T0),1 hour after prone ventilation(T1),12 hours after prone ventilation(T2),1 hour after returning to the supine position(T3),and 7 days after returning to the supine position(T4).
Neuroimaging Studies
Cranial CT or MRI Scans Conducted Before and After Prone Positioning to Detect New-Onset Neurological Complications Such as Cerebral Edema, Intracranial Hemorrhage, and Cerebral Infarction
Biomarker Detection
Blood samples were collected for NSE(Neuron-specific Enolase)and IL-6(Interleukin-6)before and after prone positioning.
Incidence rate of delirium
Assessment using the Confusion Assessment Method for the Intensive Care Unit(CAM-ICU)was conducted before and after prone position therapy in patients.
Cognitive function
Assessment using the Mini-Mental State Examination(MMSE)was conducted before and after prone position therapy in patients.
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