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Related Experiment Videos

Prone position in mechanically-ventilated patients

L Brazzi1, P Pelosi, L Gattinoni

  • 1Dept of Anaesthesia and Intensive Care, Ospedale Maggiore Policlinico IRCCS, Milan, Italy.

Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace
|November 26, 1998
PubMed
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The prone position improves oxygenation in normal and obese subjects by increasing functional residual capacity and lung compliance. In acute respiratory failure patients, prone positioning significantly enhances arterial oxygen tension, particularly when chest wall compliance is reduced.

Area of Science:

  • Respiratory Physiology
  • Critical Care Medicine

Background:

  • The prone position is utilized in respiratory therapy to aid secretion drainage.
  • Its potential to enhance oxygenation in anesthetized and paralyzed individuals has been explored.

Purpose of the Study:

  • To investigate the effects of the prone position on respiratory mechanics and oxygenation in normal, obese, and acute respiratory failure (ARF) subjects.
  • To determine the relationship between prone positioning, functional residual capacity (FRC), lung compliance (CL,st), chest wall compliance (Ccw,st), and arterial oxygen tension (Pa,O2).

Main Methods:

  • The study involved 17 normal subjects, 10 obese subjects, and 16 ARF patients.
  • Measurements included respiratory system compliance (Crs,st), FRC, CL,st, Ccw,st, and Pa,O2 in both supine and prone positions.

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  • Statistical analysis was performed to assess significant changes and correlations.

    • Main Results:

    • In normal subjects, prone positioning increased Pa,O2 and FRC without altering Crs,st.
    • Obese subjects showed increased FRC and CL,st, decreased Ccw,st, and improved Pa,O2 in the prone position.
    • ARF patients demonstrated a significant increase in Pa,O2 with prone positioning, correlated with baseline Ccw,st, despite no significant changes in FRC or compliance.

    Conclusions:

    • The prone position effectively improves oxygenation in normal and obese individuals, associated with increased FRC and lung compliance.
    • In ARF patients, prone positioning enhances oxygenation, with the degree of improvement related to chest wall compliance.
    • The findings suggest the prone position is a valuable intervention for improving gas exchange in specific patient populations.