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Intensive Care Medicine

, Volume 40, Issue 11, pp 1634–1642 | Cite as

Mechanisms of the effects of prone positioning in acute respiratory distress syndrome

  • C. Guerin
  • L. Baboi
  • J. C. Richard
Review

Abstract

Introduction

Prone positioning has been used for many years in patients with acute respiratory distress syndrome (ARDS). The initial reason for prone positioning in ARDS patients was improvement in oxygenation. It was later shown that mechanical ventilation in the prone position can be less injurious to the lung and hence the primary reason to use prone positioning is prevention of ventilator-induced lung injury (VILI).

Material and methods

A large body of physiologic benefits of prone positioning in ARDS patients accumulated but these failed to translate into clinical benefits. More recently, meta-analyses and randomized controlled trial in a specific subgroup of ARDS patients demonstrated that prone positioning can improve survival. This review covers the effects of prone positioning on oxygenation, respiratory mechanics, and VILI.

Conclusions

We conclude with the effects of prone positioning on patient outcome, in particular on survival.

Keywords

Acute respiratory distress syndrome (ARDS) Prone position Mechanical ventilation Ventilator-induced lung injury 

Notes

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

134_2014_3500_MOESM1_ESM.doc (35 kb)
Supplementary material 2 (DOC 35 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2014

Authors and Affiliations

  1. 1.Service de Réanimation MédicaleHôpital de la croix-rousse, CHU de LyonLyonFrance
  2. 2.Université de LyonLyonFrance
  3. 3.CréatisINSERMVilleurbanneFrance

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