Prone position

Current Opinion in Critical Care
Claude Guerin

Abstract

Prone position can prevent ventilator-induced lung injury in acute respiratory distress syndrome (ARDS) patients receiving conventional mechanical ventilation and, hence, may have the potential to improve survival from this basis. Even though no single randomized controlled trial has proven benefit on patient outcome until recently, two meta-analyses, one on grouped data and the other on individual data, have shown that patients with PaO2/FIO2 ratio less than 100 mmHg at the time of inclusion did benefit from prone position. As a fifth trial completed recently has shown a significant reduction in mortality in patients with severe and confirmed ARDS from using prone position, the purpose of this review is to revisit prone positioning in ARDS in the light of these new findings. In this trial done in patients with severe ARDS severity criteria (PaO2/FIO2 ratio less than 150 mmHg with positive end expiratory pressure of 5 cmH2O or more, FIO2 of 60% or more and tidal volume around 6 ml/kg predicted body weight) confirmed 12-24 h after the onset of ARDS, the day 28 mortality in the supine group (229 patients) was 32.8 versus 16% in the prone group (237 patients) (P < 0.001). Significant reduction in mortality was confirmed at day 90....Continue Reading

References

Feb 26, 1998·American Journal of Respiratory and Critical Care Medicine·P PelosiL Gattinoni
Mar 9, 2000·Critical Care Medicine·A BroccardJ J Marini
May 4, 2000·The New England Journal of Medicine·UNKNOWN Acute Respiratory Distress Syndrome NetworkArthur Wheeler
Sep 1, 2001·The New England Journal of Medicine·L GattinoniUNKNOWN Prone-Supine Study Group
Oct 22, 2003·Intensive Care Medicine·Christian Brun-BuissonUNKNOWN ALIVE Study Group
Dec 12, 2003·Critical Care Medicine·Luciano GattinoniUNKNOWN Prone-Supine Study Group
Jul 23, 2004·The New England Journal of Medicine·Roy G BrowerUNKNOWN National Heart, Lung, and Blood Institute ARDS Clinical Trials Network
Nov 18, 2004·JAMA : the Journal of the American Medical Association·Claude GuerinMichel Kaidomar
Mar 2, 2005·The European Respiratory Journal·S D MentzelopoulosS G Zakynthinos
Mar 25, 2006·American Journal of Respiratory and Critical Care Medicine·Jordi ManceboRichard K Albert
Apr 29, 2006·American Journal of Respiratory and Critical Care Medicine·Eftichia GaliatsouGeorgios Nakos
May 23, 2006·The New England Journal of Medicine·UNKNOWN National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials NetworkAndrea L Harabin
Jun 23, 2007·American Journal of Respiratory and Critical Care Medicine·Jesús VillarUNKNOWN HELP Network
Feb 14, 2008·JAMA : the Journal of the American Medical Association·Alain MercatUNKNOWN Expiratory Pressure (Express) Study Group
Jul 4, 2008·Critical Care Medicine·Jean-Christophe RichardClaude Guerin
Nov 12, 2009·JAMA : the Journal of the American Medical Association·Paolo TacconeUNKNOWN Prone-Supine II Study Group
Sep 17, 2010·The New England Journal of Medicine·Laurent PapazianUNKNOWN ACURASYS Study Investigators
May 13, 2011·American Journal of Respiratory and Critical Care Medicine·UNKNOWN National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials NetworkB Taylor Thompson
Aug 29, 2012·Intensive Care Medicine·Niall D FergusonV Marco Ranieri
Jan 24, 2013·The New England Journal of Medicine·Duncan YoungUNKNOWN OSCAR Study Group
Jan 24, 2013·The New England Journal of Medicine·Niall D FergusonUNKNOWN Canadian Critical Care Trials Group
Jan 26, 2013·American Journal of Respiratory and Critical Care Medicine·Rodrigo A CornejoGonzalo L Pereira
Feb 2, 2013·Intensive Care Medicine·Jesús VillarUNKNOWN Spanish Initiative for Epidemiology, Stratification, and Therapies for ARDS (SIESTA) Network
May 22, 2013·The New England Journal of Medicine·Claude GuérinUNKNOWN PROSEVA Study Group

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Citations

Apr 15, 2016·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·J D DellaVolpeF X Guyette
Jun 17, 2016·Revista da Associação Médica Brasileira·Vanessa Martins de OliveiraSilvia Regina Rios Vieira
Jul 28, 2017·The Clinical Respiratory Journal·Yuanda XuNanshan Zhong
May 7, 2016·World Journal of Critical Care Medicine·Vasilios KoulourasGeorgios Nakos
Dec 3, 2016·Critical Care : the Official Journal of the Critical Care Forum·Xiao-Ting WangUNKNOWN Chinese Critical Ultrasound Study Group (CCUSG)
Jul 30, 2021·International Journal of Clinical Practice·İhsan AteşAhmet Omma

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