PMC2999721_01
X-ray computed tomography of the thorax showing diffuse, patchy bilateral ground glass opacities and consolidation at ICU admission.
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Arterial blood gas analysis confirmed severe hypoxemia, and an X-ray computed tomography (CT) scan (Figure 1) of the thorax showed bilateral pulmonary infiltrates.
Recruitment maneuver (R); Prone position (P).
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After the recruitment, the PEEP was titrated at 18 cm H2O according to the best dynamic compliance, but there was no significant improvement in the PaO2/FiO2 ratio (Figure 2). A decision was then made to repeat the recruitment maneuver with the patient in the prone position, which resulted in significant improvement in gas exchange (Figure 2). Mechanical ventilation in the prone position for an average of 12 hours/day and one daily recruitment maneuver were continued for three consecutive days, with progressive improvement in the gas exchange (Figure 2).