A Framework for Developing a Multidisciplinary Approach to Prone Positioning in Acute Respiratory Distress Syndrome.

Area of Science:

• Critical Care Medicine
• Pulmonology
• Respiratory Therapy

Background:

• Prone position ventilation (PPV) is a key intervention for acute respiratory distress syndrome (ARDS), demonstrating mortality benefits.
• Despite proven efficacy, PPV is underutilized in clinical practice, with significant implementation barriers identified.
• The complex nature of multidisciplinary team collaboration poses challenges to consistent PPV application.

Purpose of the Study:

• To present a framework for multidisciplinary collaboration to identify appropriate patients for PPV.
• To discuss institutional experience implementing PPV using a multidisciplinary team approach, including during the COVID-19 pandemic.
• To highlight the role of multidisciplinary teams in effective PPV implementation across a healthcare system.

Main Methods:

• Development of a multidisciplinary team framework for patient selection in ARDS.
• Review of institutional experience with PPV implementation and management.
• Emphasis on protocolized patient selection for prone positioning.

Main Results:

• A structured, multidisciplinary approach facilitates the identification and application of PPV in ARDS patients.
• Implementation of a collaborative framework can overcome barriers to PPV utilization.
• The framework proved effective in guiding PPV during the COVID-19 pandemic.

Conclusions:

• Multidisciplinary collaboration is crucial for optimizing PPV use in ARDS.
• A protocolized approach to patient selection enhances the effective implementation of PPV.
• System-wide application of this framework can improve ARDS outcomes through increased PPV utilization.