Monday April 28 , 2008
Prone Position: Is it still on in ARDS patients

Recently published meta- analysis of thirteen trials that enrolled a total of 1559 patients were studied. In 10 of those trials (n=1486) they found that prone positioning did not reduce mortality among hypoxemic patients. The lack of effect of ventilation in the prone position on mortality was similar in trials of prolonged prone positioning and in patients with acute lung injury.

Even though it does not reduce the mortality, but it did increase the oxygenation by 34% on day 1 in 8 of the trials. In 5 trials (n=1004), prone positioning was associated with a reduced risk of ventilator associated pneumonia.

Conclusion: Mechanical ventilation in the prone position does not reduce mortality or duration of ventilation despite improved oxygenation and a decreased risk of pneumonia.


Reference: click to get abstract / article

Sud S, Sud M, Friedrich JO, Adhikari NKJ. Effect of mechanical ventilation in the prone position on clinical outcomes in patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis. CMAJ 2008; 178(9), full text here