Prone position in ARDS patients: why, when, how and for whom.
Intensive Care Med
; 46(12): 2385-2396, 2020 12.
Article
in English
| MEDLINE | ID: covidwho-917110
ABSTRACT
In ARDS patients, the change from supine to prone position generates a more even distribution of the gas-tissue ratios along the dependent-nondependent axis and a more homogeneous distribution of lung stress and strain. The change to prone position is generally accompanied by a marked improvement in arterial blood gases, which is mainly due to a better overall ventilation/perfusion matching. Improvement in oxygenation and reduction in mortality are the main reasons to implement prone position in patients with ARDS. The main reason explaining a decreased mortality is less overdistension in non-dependent lung regions and less cyclical opening and closing in dependent lung regions. The only absolute contraindication for implementing prone position is an unstable spinal fracture. The maneuver to change from supine to prone and vice versa requires a skilled team of 4-5 caregivers. The most frequent adverse events are pressure sores and facial edema. Recently, the use of prone position has been extended to non-intubated spontaneously breathing patients affected with COVID-19 ARDS. The effects of this intervention on outcomes are still uncertain.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Respiratory Distress Syndrome
/
Respiratory Mechanics
/
Prone Position
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Intensive Care Med
Year:
2020
Document Type:
Article
Affiliation country:
S00134-020-06306-w
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