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An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
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Prone position in ARDS patients: why, when, how and for whom
Claude Guérin1,2,3, Richard K Albert4, Jeremy Beitler5
1Médecine Intensive-Réanimation, Hôpital Edoudard Herriot, Lyon, France.
Intensive Care Medicine
|November 10, 2020
Summary
Prone positioning in Acute Respiratory Distress Syndrome (ARDS) improves lung mechanics and oxygenation, potentially reducing mortality by optimizing ventilation and minimizing lung injury. This technique requires careful management and is being explored in non-intubated patients.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
Background:
- Acute Respiratory Distress Syndrome (ARDS) is characterized by severe hypoxemia and lung inflammation.
- Prone positioning is a ventilatory strategy used to improve gas exchange in ARDS patients.
Purpose of the Study:
- To summarize the physiological effects and clinical outcomes of prone positioning in ARDS.
- To discuss the application and potential benefits of prone positioning in COVID-19 ARDS.
Main Methods:
- Review of physiological changes associated with prone positioning.
- Analysis of clinical outcomes, including mortality and adverse events.
- Discussion of recent extensions of prone positioning to non-intubated patients.
Main Results:
- Prone positioning leads to more homogeneous lung stress and strain distribution.
- Improved ventilation/perfusion matching enhances arterial blood gases and oxygenation.
- Reduced mortality is associated with decreased lung overdistension and cyclic atelectasis.
Conclusions:
- Prone positioning is a key intervention for ARDS, improving oxygenation and reducing mortality.
- Careful patient selection and a skilled team are necessary to manage prone positioning.
- The efficacy of prone positioning in non-intubated COVID-19 ARDS patients requires further investigation.
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