Abstract
Prone positioning, i.e., installing the patient face down in the bed while receiving mechanical ventilation, is an old technique that has been used for many years to successfully improve oxygenation in ARDS patients. It has proven benefit to improve survival in patients with ARDS and severity criteria based on oxygenation in a single randomized controlled trial, which has confirmed previous meta-analyses.
This beneficial effect on patient outcome likely stems from prevention of ventilator-induced lung injury and preservation of hemodynamics. It should be used early in the course of ARDS, in patients with severe oxygenation impairment. It should not be seen as a rescue intervention, even though it can be used as such in case of refractory hypoxemia.
This chapter summarizes the physiological effects of proning on oxygenation and lung protection, the clinical effects on mortality and the presumed mechanisms by which this effect may result from, and the application of this technique in the clinical practice.
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Guérin, C. (2017). Prone Position. In: Chiumello, D. (eds) Acute Respiratory Distress Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-319-41852-0_6
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DOI: https://doi.org/10.1007/978-3-319-41852-0_6
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