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Updated: Jul 13, 2026
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An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
Alveolar recruitment during prone position: time matters
Jörg Reutershan1, Andre Schmitt, Klaus Dietz
1Department of Anesthesiology and Intensive Care Medicine, University of Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany. joerg.reutershan@med.uni-tuebingen.de
Clinical Science (London, England : 1979)
|February 3, 2006
Summary
Prone positioning aids acute respiratory distress syndrome (ARDS) patients by increasing lung volume, but recruitment varies individually over time. Measuring this response can help personalize ARDS treatment.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
Background:
- Prone positioning improves oxygenation in acute respiratory distress syndrome (ARDS).
- Patient responses to prone positioning vary, suggesting individual differences in alveolar recruitment.
Purpose of the Study:
- To investigate alveolar recruitment as an individual, time-dependent process during prone positioning in ARDS.
- To determine if measuring end-expiratory lung volume (EELV) can help personalize prone positioning therapy.
Main Methods:
- Measured EELV in 13 ARDS patients at multiple time points during supine and prone positioning.
- Defined responders based on a 30% increase in oxygenation.
- Analyzed the time course of EELV changes and correlated them with oxygenation and venous admixture.
Main Results:
- EELV increased in responders but not non-responders.
- Alveolar recruitment occurred at different rates among individuals, with some reaching a plateau early and others requiring longer.
- Increased lung volume correlated with improved oxygenation and reduced venous admixture.
- Responders had lower baseline EELVs than non-responders.
Conclusions:
- Alveolar recruitment during prone positioning is an individual, time-dependent process.
- Monitoring EELV changes may allow for individualized 'dosing' of prone positioning.
- This approach could help identify patients who will benefit most from prone positioning.
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