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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Response of MP and its partitioned components during the evaluation times A&#41; Dynamic Power B&#41; Elastic Power C&#41; Driving Power D&#41; Mechanical power &#40;MP&#41;&#44; during supine &#40;SUP&#41;&#44; immediate &#40;PP&#95;1&#41; and late prone position &#40;PP&#95;2&#41;&#46; Data are expressed as median &#40;Q1-Q3&#41;&#46; &#35; and &#42;&#58; <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;0&#46;005&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Prone positioning &#40;PP&#41; improves survival in moderate-severe acute respiratory distress syndrome induced by coronavirus-19 &#40;C-ARDS&#41;&#46; The attenuation of ventilator-induced lung injury &#40;VILI&#41; represents the most plausible mechanism resulting in reduced mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The mechanical power &#40;MP&#41; has been recently proposed by Gattinoni et al&#46; as a unifying concept aiming to reflect the risk of VILI by integrating information about the ventilatory settings and respiratory mechanics&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The first aim of our study was to describe the effects of the first session of PP on MP in moderate-severe C-ARDS&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We carried out a prospective cohort study in the intensive care unit &#40;ICU&#41; of the Sanatorio Anchorena San Mart&#237;n&#44; Buenos Aires&#46; Consecutive sedated and paralyzed adults with moderate-severe C-ARDS who required invasive ventilation and PP were included&#46; We excluded patients without neuromuscular blockers&#44; not drained pneumothorax&#44; bronchopleural fistula and obstructive pulmonary disease&#46; The study was approved by the local review board &#40;code&#35;11&#47;2020&#41; and was registered in clinicaltrials&#46;gov &#40;NCT04369105&#41;&#46; The informed consent was obtained in all patients and they were ventilated in volume-controlled mode set-point &#40;VC-CMVs&#41;&#44; with tidal volume &#40;VT&#41; of 4&#8722;8&#160;mL&#47;Kg of predicted body weight&#44; plateau pressure &#60;30cmH2O and driving pressure &#40;DP&#41; &#60;15cmH<span class="elsevierStyleInf">2</span>O&#46; PEEP level was selected by a 2-cmH<span class="elsevierStyleInf">2</span>O stepwise decremental titration without prior recruitment and the lowest PEEP associated with higher compliance &#40;Crs&#41; was set&#46; The respiratory rate was adjusted to pH between 7&#46;25&#8211;7&#46;35 and the inspired oxygen to peripheral oxygen saturation between 90&#8211;95 &#37;&#46; The patients were deeply sedated &#40;target RASS -5&#41; with propofol and fentanyl and received neuromuscular blockade with atracurium&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">We calculated MP at three time-points&#58; 1&#41; supine &#40;SUP&#41;&#44; within 15&#160;min before PP&#59; 2&#41; within the 15&#160;min after PP &#40;PP&#95;1&#41; keeping the same ventilatory settings that SUP&#59; 3&#41; after 2&#8722;4&#160;h of PP &#40;PP&#95;2&#41;&#46; In PP&#95;2&#44; changes in ventilator setting were permitted at physician&#8217;s discretion&#46; Secretions were properly suctioned prior to data collection besides&#44; we collected arterial blood gasses at SUP and PP&#95;2&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Our main end-point was the MP calculated through the original<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#58;<elsevierMultimedia ident="eq0005"></elsevierMultimedia></p><p id="par0035" class="elsevierStylePara elsevierViewall">In addition&#44; considering the uncertain impact of the resistive pressure gradient on VILI pathophysiology&#44; but the clear link between VILI and DP&#44; we analyzed the pure behavior of elastic loads in MP calculations according to Dianti et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#58;<elsevierMultimedia ident="eq0010"></elsevierMultimedia></p><p id="par0040" class="elsevierStylePara elsevierViewall">To isolate the influence of dynamic strain&#44; we also computed the dynamic and driving MP excluding the static strain component &#40;i&#46;e&#46;&#44; considering PEEP&#160;&#61;&#160;0cmH<span class="elsevierStyleInf">2</span>O&#41;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#58;<elsevierMultimedia ident="eq0015"></elsevierMultimedia><elsevierMultimedia ident="eq0020"></elsevierMultimedia></p><p id="par0045" class="elsevierStylePara elsevierViewall">Continuous data are expressed with mean &#40;SD&#41; or median &#91;quartile 25&#8211;75&#93; according to normality checked by Shapiro-Wilk test&#46; Categorical data are expressed as number &#40;&#37;&#41;&#46; Comparisons between MP forms&#44; ventilator settings and monitoring variables were tested by one-way ANOVA or Friedman test and <span class="elsevierStyleItalic">p</span>-values were adjusted by post-hoc Tukey&#8217;s or Dunn&#8217;s correction&#46; Gas exchange response was compared with <span class="elsevierStyleItalic">t</span>-test or Wilcoxon-Mann-Whitney test&#44; as appropriate&#46; In a post-hoc analysis&#44; we investigated potential predictors of response in cases where prone induced significant effects&#46; A linear model was fitted with the following continuous predictors&#44; all collected a priori in supine&#58; PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span>&#44; Crs and PEEP&#46; A two-tailed <span class="elsevierStyleItalic">p</span>-value &#60;0&#46;05 was considered statistically significant&#46; The analysis was performed with GraphPad Prism 8&#46;4&#174;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">We studied 70 C-ARDS from July 2020 to September 2021&#46; The patients were 60 &#40;13&#41; years-old and were predominantly male &#40;65&#37;&#41;&#46; The APACHE II at admission was 13 &#91;10&#8211;17&#93; points&#44; 86&#37; had moderate-ARDS and 14&#37; had severe-ARDS&#46; The total MV duration was 13 &#91;6&#8211;22&#93; days&#44; the ICU stay was 15 &#91;8&#8211;25&#93; days and the ICU mortality was 57&#37;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">At the time of first PP session&#44; the patients had 3 &#91;1&#8211;6&#93; days of intubation and a PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span> of 134 &#40;37&#46;3&#41; mmHg &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> depicts the response of MP to prone positioning&#46; Although MP<span class="elsevierStyleInf">global</span> did not change immediately &#40;mean-change &#40;95&#37; CI&#41;&#58; 0&#46;13 &#40;&#8722;0&#46;18 to 0&#46;40&#41;&#59; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;0&#46;840&#41; or after 2&#8722;4&#160;h &#40;&#8722;0&#46;02 &#40;&#8722;0&#46;38 to 0&#46;35&#41;&#59; <span class="elsevierStyleItalic">p</span>&#160;&#62;&#160;0&#46;990&#41;&#44; PP reduced Dynamic-Power &#40;&#8722;0&#46;60 &#40;&#8722;0&#46;86 to 0&#46;30&#41; J&#47;min&#59; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;0&#46;0006&#41; and Driving-Power &#40;&#8722;44&#46;4 &#40;&#8722;72 to &#8722;16&#46;8&#41; cmH<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleSup">2</span>&#47;min&#59; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;0&#46;001&#41; in PP&#95;2&#46; The only variable that predicted Driving-Power response was the Crs prior to prone &#40;<span class="elsevierStyleItalic">&#946;</span>&#160;&#61;&#160;3&#46;36 &#40;standard-error&#58; 1&#46;05&#8211;6&#46;26&#41;&#59; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;0&#46;007&#41; &#40;Table SM1&#41;&#46; The response of Dynamic-Power was not predicted by any of the variables evaluated &#40;Table SM2&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">This study showed that prone ventilation did not produce significant effects on MP<span class="elsevierStyleInf">global</span> but it may reduce the elastic energy applied to the respiratory system in C-ARDS patients&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The null impact of prone on MP<span class="elsevierStyleInf">global</span> may have different explanations&#58; first&#44; PP has been shown to make ventilation more homogeneous and reduce regional pulmonary stress&#47;strain<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#59; MP<span class="elsevierStyleInf">global</span> may not be able to capture such regional changes&#46; We found improvement in oxygenation and mild increase in Crs&#44; suggesting that recruitment occurred through redistribution of ventilation to dorsal zones&#46; Second&#44; the time until PP2 may not have been sufficient to find full benefits on gas exchange and&#47;or respiratory mechanics&#46; Accordingly&#44; improvements in CO<span class="elsevierStyleInf">2</span> clearance&#44; compliance&#44; dead space&#44; and oxygenation have been shown to be greater as the time of the prone is prolonged&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> This fact could have enabled clinicians to modify ventilator settings &#40;e&#46;g&#46;&#44; reduce RR&#44; flow or PEEP&#41; and reduce MP&#59; third&#44; the original MP formula includes the resistive component&#44; which is not expected to change significantly with PP after adequate secretion suctioning&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">When resistive loads were excluded from MP calculation&#44; PP significantly reduced Dynamic-Power and Driving-Power&#46; Both calculations integrate Ers&#44; RR and DP&#44; all variables that were significantly reduced at PP2&#46; On another side&#44; we observed that the lower Crs in supine&#44; the higher Driving-Power reduction with prone&#46; Although baseline oxygenation did not predict prone response&#44; these findings support the PROSEVA trial results and suggest that PP may have larger impact on VILI risk in patients with sicker lungs&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">This study presents important limitations&#58; we did not measure transpulmonary MP&#44; which might show more accurate effects of PP regarding the risk of VILI&#46; The changes in ventilator settings in PP2 were not protocolized and constitutes a bias which could have influenced the results&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In summary&#44; our study suggests that PP is not associated with a reduction in MP<span class="elsevierStyleInf">global</span> in the short term in C-ARDS&#44; but may reduce the elastic energy after a 2&#8722;4&#160;h of prone&#46; Future research should explore whether a more prolonged follow-up during a prone session could reveal greater improvement in gas exchange and&#47;or mechanics&#44; which may allow for more profound modifications of ventilator settings conditioning greater MP reductions&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Contributions</span><p id="par0085" class="elsevierStylePara elsevierViewall">MA leaded the project and performed the literature search&#59; MA&#44; JHD&#44; JP&#44; GPC and DIG carried out the data collection process and planned the study design&#59; JP performed the analysis of data&#59; MA&#44; JHD&#44; JP&#44; GPC&#44; MNB and DIG actively participated in the manuscript preparation&#59; all the authors reviewed and approved the final manuscript&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Sources of financial support</span><p id="par0090" class="elsevierStylePara elsevierViewall">This study did not receive any grant or external financial support&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interest</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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            "apendice" => "<p id="par0105" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
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            "identificador" => "sec0025"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Response of MP and its partitioned components during the evaluation times A&#41; Dynamic Power B&#41; Elastic Power C&#41; Driving Power D&#41; Mechanical power &#40;MP&#41;&#44; during supine &#40;SUP&#41;&#44; immediate &#40;PP&#95;1&#41; and late prone position &#40;PP&#95;2&#41;&#46; Data are expressed as median &#40;Q1-Q3&#41;&#46; &#35; and &#42;&#58; <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;0&#46;005&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables &#40;n&#61;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Baseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PP1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PP2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Primary outcome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mechanical power &#40;J&#47;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;6 &#91;17&#46;1&#8722;25&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;8 &#91;17&#46;5&#8722;26&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;1 &#91;17&#46;7&#8722;25&#46;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5704&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Elastic power &#40;J&#47;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;28 &#91;3&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;06 &#91;3&#46;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;79 &#91;3&#46;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0838&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dynamic power &#40;J&#47;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;26 &#91;1&#46;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;06 &#91;1&#46;34&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;81 &#91;1&#46;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0006<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#11361;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Driving power &#40;cmH<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleSup">2</span>&#47;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">290 &#91;210&#8722;410&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">270 &#91;180&#8722;390&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">260 &#91;180&#8722;360&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#11361;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Setting and monitoring variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tidal volume &#40;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;39 &#91;0&#46;07&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;39 &#91;0&#46;07&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;38 &#91;0&#46;07&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;097&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PEEP &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#91;8&#8722;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#91;8&#8722;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#91;8&#8722;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3247&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PEEP Total &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#91;8&#8722;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;9 &#91;8&#8722;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;63 &#91;8&#46;1&#8722;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span>0&#46;0001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#11361;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Respiratory rate &#40;breaths&#47;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#91;22&#8722;27&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#91;22&#8722;27&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#91;22&#8722;27&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0381<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#11361;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Driving pressure &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#91;10&#8722;12&#46;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;57 &#91;9&#8722;11&#46;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#91;9&#8722;11&#46;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;0008<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#11361;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Respiratory system Compliance &#40;mL&#47;cmH<span class="elsevierStyleInf">2</span>O&#41;&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Prone position&#8211;induced improvement in gas exchange does not predict improved survival in the acute respiratory distress syndrome &#91;Internet&#93;"
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Scientific Letter
Does prone positioning decrease mechanical power in C-ARDS?
Puede el decúbito prono disminuir la energía mecánica en C-SDRA?
Matías Accocea,b,c,
Autor para correspondencia
matiasaccoce@gmail.com

Corresponding author at: Perdriel 4189, Villa Lynch. CP 1650. Sanatorio Anchorena San Martín, Buenos Aires, Argentina.
, Javier Hernan Doradoa, Gimena Paola Cardosoa,d, Matías Nicolas Bertozzia,d, Daniela Ines Gilgadoa,d, Joaquín Péreza
a Sanatorio Anchorena San Martín, Buenos Aires, Argentina
b Universidad Abierta Interamericana, Facultad de Medicina y Ciencias de la Salud, Buenos Aires, Argentina
c Hospital de Quemados, Ciudad Autónoma de Buenos Aires, Argentina
d Hospital Donación “Francisco Santojanni”, Buenos Aires, Argentina
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Prone positioning &#40;PP&#41; improves survival in moderate-severe acute respiratory distress syndrome induced by coronavirus-19 &#40;C-ARDS&#41;&#46; The attenuation of ventilator-induced lung injury &#40;VILI&#41; represents the most plausible mechanism resulting in reduced mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The mechanical power &#40;MP&#41; has been recently proposed by Gattinoni et al&#46; as a unifying concept aiming to reflect the risk of VILI by integrating information about the ventilatory settings and respiratory mechanics&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The first aim of our study was to describe the effects of the first session of PP on MP in moderate-severe C-ARDS&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We carried out a prospective cohort study in the intensive care unit &#40;ICU&#41; of the Sanatorio Anchorena San Mart&#237;n&#44; Buenos Aires&#46; Consecutive sedated and paralyzed adults with moderate-severe C-ARDS who required invasive ventilation and PP were included&#46; We excluded patients without neuromuscular blockers&#44; not drained pneumothorax&#44; bronchopleural fistula and obstructive pulmonary disease&#46; The study was approved by the local review board &#40;code&#35;11&#47;2020&#41; and was registered in clinicaltrials&#46;gov &#40;NCT04369105&#41;&#46; The informed consent was obtained in all patients and they were ventilated in volume-controlled mode set-point &#40;VC-CMVs&#41;&#44; with tidal volume &#40;VT&#41; of 4&#8722;8&#160;mL&#47;Kg of predicted body weight&#44; plateau pressure &#60;30cmH2O and driving pressure &#40;DP&#41; &#60;15cmH<span class="elsevierStyleInf">2</span>O&#46; PEEP level was selected by a 2-cmH<span class="elsevierStyleInf">2</span>O stepwise decremental titration without prior recruitment and the lowest PEEP associated with higher compliance &#40;Crs&#41; was set&#46; The respiratory rate was adjusted to pH between 7&#46;25&#8211;7&#46;35 and the inspired oxygen to peripheral oxygen saturation between 90&#8211;95 &#37;&#46; The patients were deeply sedated &#40;target RASS -5&#41; with propofol and fentanyl and received neuromuscular blockade with atracurium&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">We calculated MP at three time-points&#58; 1&#41; supine &#40;SUP&#41;&#44; within 15&#160;min before PP&#59; 2&#41; within the 15&#160;min after PP &#40;PP&#95;1&#41; keeping the same ventilatory settings that SUP&#59; 3&#41; after 2&#8722;4&#160;h of PP &#40;PP&#95;2&#41;&#46; In PP&#95;2&#44; changes in ventilator setting were permitted at physician&#8217;s discretion&#46; Secretions were properly suctioned prior to data collection besides&#44; we collected arterial blood gasses at SUP and PP&#95;2&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Our main end-point was the MP calculated through the original<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#58;<elsevierMultimedia ident="eq0005"></elsevierMultimedia></p><p id="par0035" class="elsevierStylePara elsevierViewall">In addition&#44; considering the uncertain impact of the resistive pressure gradient on VILI pathophysiology&#44; but the clear link between VILI and DP&#44; we analyzed the pure behavior of elastic loads in MP calculations according to Dianti et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#58;<elsevierMultimedia ident="eq0010"></elsevierMultimedia></p><p id="par0040" class="elsevierStylePara elsevierViewall">To isolate the influence of dynamic strain&#44; we also computed the dynamic and driving MP excluding the static strain component &#40;i&#46;e&#46;&#44; considering PEEP&#160;&#61;&#160;0cmH<span class="elsevierStyleInf">2</span>O&#41;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#58;<elsevierMultimedia ident="eq0015"></elsevierMultimedia><elsevierMultimedia ident="eq0020"></elsevierMultimedia></p><p id="par0045" class="elsevierStylePara elsevierViewall">Continuous data are expressed with mean &#40;SD&#41; or median &#91;quartile 25&#8211;75&#93; according to normality checked by Shapiro-Wilk test&#46; Categorical data are expressed as number &#40;&#37;&#41;&#46; Comparisons between MP forms&#44; ventilator settings and monitoring variables were tested by one-way ANOVA or Friedman test and <span class="elsevierStyleItalic">p</span>-values were adjusted by post-hoc Tukey&#8217;s or Dunn&#8217;s correction&#46; Gas exchange response was compared with <span class="elsevierStyleItalic">t</span>-test or Wilcoxon-Mann-Whitney test&#44; as appropriate&#46; In a post-hoc analysis&#44; we investigated potential predictors of response in cases where prone induced significant effects&#46; A linear model was fitted with the following continuous predictors&#44; all collected a priori in supine&#58; PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span>&#44; Crs and PEEP&#46; A two-tailed <span class="elsevierStyleItalic">p</span>-value &#60;0&#46;05 was considered statistically significant&#46; The analysis was performed with GraphPad Prism 8&#46;4&#174;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">We studied 70 C-ARDS from July 2020 to September 2021&#46; The patients were 60 &#40;13&#41; years-old and were predominantly male &#40;65&#37;&#41;&#46; The APACHE II at admission was 13 &#91;10&#8211;17&#93; points&#44; 86&#37; had moderate-ARDS and 14&#37; had severe-ARDS&#46; The total MV duration was 13 &#91;6&#8211;22&#93; days&#44; the ICU stay was 15 &#91;8&#8211;25&#93; days and the ICU mortality was 57&#37;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">At the time of first PP session&#44; the patients had 3 &#91;1&#8211;6&#93; days of intubation and a PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span> of 134 &#40;37&#46;3&#41; mmHg &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> depicts the response of MP to prone positioning&#46; Although MP<span class="elsevierStyleInf">global</span> did not change immediately &#40;mean-change &#40;95&#37; CI&#41;&#58; 0&#46;13 &#40;&#8722;0&#46;18 to 0&#46;40&#41;&#59; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;0&#46;840&#41; or after 2&#8722;4&#160;h &#40;&#8722;0&#46;02 &#40;&#8722;0&#46;38 to 0&#46;35&#41;&#59; <span class="elsevierStyleItalic">p</span>&#160;&#62;&#160;0&#46;990&#41;&#44; PP reduced Dynamic-Power &#40;&#8722;0&#46;60 &#40;&#8722;0&#46;86 to 0&#46;30&#41; J&#47;min&#59; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;0&#46;0006&#41; and Driving-Power &#40;&#8722;44&#46;4 &#40;&#8722;72 to &#8722;16&#46;8&#41; cmH<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleSup">2</span>&#47;min&#59; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;0&#46;001&#41; in PP&#95;2&#46; The only variable that predicted Driving-Power response was the Crs prior to prone &#40;<span class="elsevierStyleItalic">&#946;</span>&#160;&#61;&#160;3&#46;36 &#40;standard-error&#58; 1&#46;05&#8211;6&#46;26&#41;&#59; <span class="elsevierStyleItalic">p</span>&#160;&#61;&#160;0&#46;007&#41; &#40;Table SM1&#41;&#46; The response of Dynamic-Power was not predicted by any of the variables evaluated &#40;Table SM2&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">This study showed that prone ventilation did not produce significant effects on MP<span class="elsevierStyleInf">global</span> but it may reduce the elastic energy applied to the respiratory system in C-ARDS patients&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The null impact of prone on MP<span class="elsevierStyleInf">global</span> may have different explanations&#58; first&#44; PP has been shown to make ventilation more homogeneous and reduce regional pulmonary stress&#47;strain<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#59; MP<span class="elsevierStyleInf">global</span> may not be able to capture such regional changes&#46; We found improvement in oxygenation and mild increase in Crs&#44; suggesting that recruitment occurred through redistribution of ventilation to dorsal zones&#46; Second&#44; the time until PP2 may not have been sufficient to find full benefits on gas exchange and&#47;or respiratory mechanics&#46; Accordingly&#44; improvements in CO<span class="elsevierStyleInf">2</span> clearance&#44; compliance&#44; dead space&#44; and oxygenation have been shown to be greater as the time of the prone is prolonged&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> This fact could have enabled clinicians to modify ventilator settings &#40;e&#46;g&#46;&#44; reduce RR&#44; flow or PEEP&#41; and reduce MP&#59; third&#44; the original MP formula includes the resistive component&#44; which is not expected to change significantly with PP after adequate secretion suctioning&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">When resistive loads were excluded from MP calculation&#44; PP significantly reduced Dynamic-Power and Driving-Power&#46; Both calculations integrate Ers&#44; RR and DP&#44; all variables that were significantly reduced at PP2&#46; On another side&#44; we observed that the lower Crs in supine&#44; the higher Driving-Power reduction with prone&#46; Although baseline oxygenation did not predict prone response&#44; these findings support the PROSEVA trial results and suggest that PP may have larger impact on VILI risk in patients with sicker lungs&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">This study presents important limitations&#58; we did not measure transpulmonary MP&#44; which might show more accurate effects of PP regarding the risk of VILI&#46; The changes in ventilator settings in PP2 were not protocolized and constitutes a bias which could have influenced the results&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In summary&#44; our study suggests that PP is not associated with a reduction in MP<span class="elsevierStyleInf">global</span> in the short term in C-ARDS&#44; but may reduce the elastic energy after a 2&#8722;4&#160;h of prone&#46; Future research should explore whether a more prolonged follow-up during a prone session could reveal greater improvement in gas exchange and&#47;or mechanics&#44; which may allow for more profound modifications of ventilator settings conditioning greater MP reductions&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Contributions</span><p id="par0085" class="elsevierStylePara elsevierViewall">MA leaded the project and performed the literature search&#59; MA&#44; JHD&#44; JP&#44; GPC and DIG carried out the data collection process and planned the study design&#59; JP performed the analysis of data&#59; MA&#44; JHD&#44; JP&#44; GPC&#44; MNB and DIG actively participated in the manuscript preparation&#59; all the authors reviewed and approved the final manuscript&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Sources of financial support</span><p id="par0090" class="elsevierStylePara elsevierViewall">This study did not receive any grant or external financial support&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interest</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Response of MP and its partitioned components during the evaluation times A&#41; Dynamic Power B&#41; Elastic Power C&#41; Driving Power D&#41; Mechanical power &#40;MP&#41;&#44; during supine &#40;SUP&#41;&#44; immediate &#40;PP&#95;1&#41; and late prone position &#40;PP&#95;2&#41;&#46; Data are expressed as median &#40;Q1-Q3&#41;&#46; &#35; and &#42;&#58; <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;0&#46;005&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables &#40;n&#61;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Baseline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PP1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PP2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Primary outcome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mechanical power &#40;J&#47;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;6 &#91;17&#46;1&#8722;25&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;8 &#91;17&#46;5&#8722;26&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;1 &#91;17&#46;7&#8722;25&#46;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5704&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Elastic power &#40;J&#47;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;28 &#91;3&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;06 &#91;3&#46;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;79 &#91;3&#46;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0838&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dynamic power &#40;J&#47;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;26 &#91;1&#46;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;06 &#91;1&#46;34&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;81 &#91;1&#46;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0006<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#11361;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Driving power &#40;cmH<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleSup">2</span>&#47;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">290 &#91;210&#8722;410&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">270 &#91;180&#8722;390&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">260 &#91;180&#8722;360&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#11361;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Setting and monitoring variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tidal volume &#40;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;39 &#91;0&#46;07&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;39 &#91;0&#46;07&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;38 &#91;0&#46;07&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;097&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PEEP &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#91;8&#8722;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#91;8&#8722;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#91;8&#8722;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3247&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PEEP Total &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#91;8&#8722;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;9 &#91;8&#8722;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;63 &#91;8&#46;1&#8722;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span>0&#46;0001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#11361;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Respiratory rate &#40;breaths&#47;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#91;22&#8722;27&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#91;22&#8722;27&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#91;22&#8722;27&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0381<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#11361;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Driving pressure &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#91;10&#8722;12&#46;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;57 &#91;9&#8722;11&#46;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#91;9&#8722;11&#46;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0008<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#11361;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Respiratory system Compliance &#40;mL&#47;cmH<span class="elsevierStyleInf">2</span>O&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46;9 &#91;11&#46;28&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46;9 &#91;12&#46;45&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;5 &#91;12&#46;37&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0011<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#11361;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Inspiratory Resistance &#40;cmH<span class="elsevierStyleInf">2</span>O&#47;L&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;8 &#91;10&#46;1&#8722;13&#46;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;5 &#91;11&#46;2&#8722;15&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;1 &#91;10&#46;5&#8722;14&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0731&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gas exchange&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span> ratio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">134 &#91;27&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">177 &#91;44&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span>0&#46;0001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#11361;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ventilatory ratio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;06 &#91;1&#46;7&#8722;2&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;94 &#91;1&#46;7&#8722;2&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;4218&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PaCO<span class="elsevierStyleInf">2</span> &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#46;4 &#91;45&#46;3&#8722;56&#46;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#46;0 &#91;43&#46;7&#8722;57&#46;0&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;7159&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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