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Enhanced glomerular thrombosis in pronated animals with ARDS.

Intensive care medicine experimental2025-03-20PubMed
Total: 70.0Innovation: 8Impact: 6Rigor: 7Citation: 6

Summary

In a randomized porcine ARDS model, prone positioning was linked to enhanced glomerular thrombosis and reduced renal perfusion, assessed by multimodal PET-MRI and tissue analyses. Findings highlight potential renal risks of pronation despite known pulmonary benefits.

Key Findings

  • Prone positioning was associated with enhanced glomerular thrombosis in a porcine ARDS model.
  • Renal perfusion was lower in pronated animals, assessed by PET-MRI and tissue analyses.

Clinical Implications

During proning in ARDS, intensify renal monitoring and consider anticoagulation and hemodynamic strategies to mitigate renal hypoperfusion and microthrombosis risk.

Why It Matters

Challenges the assumption that prone positioning is uniformly benign by revealing renal microvascular consequences in ARDS.

Limitations

  • Small sample size and short (6-hour) observation period
  • Animal model findings may not directly generalize to human ARDS

Future Directions

Prospective clinical studies to quantify renal perfusion/thrombosis during proning and to test protective anticoagulation or positioning strategies.

Study Information

Study Type
RCT
Research Domain
Pathophysiology
Evidence Level
V - Randomized animal experiment providing preclinical physiological insights
Study Design
OTHER