Tags

Type your tag names separated by a space and hit enter

Should prone positioning be routinely used for lung protection during mechanical ventilation?
Respir Care. 2010 Jan; 55(1):88-99.RC

Abstract

Prone positioning has been known for decades to improve oxygenation in animals with acute lung injury and in most patients with acute respiratory distress syndrome (ARDS). The mechanisms of this improvement include a more uniform pleural-pressure gradient, a smaller volume of lung compressed by the heart, and more uniform and better-matched ventilation and perfusion. Prone positioning has an established niche as an intervention to improve gas exchange in patients with severe hypoxemia refractory to standard ventilatory manipulations. Because the lung may be more uniformly recruited and the stress of mechanical ventilation better distributed, prone positioning has also been proposed as a form of lung-protective ventilation. However, several randomized trials have failed to show improvements in clinical outcomes of ARDS patients, other than consistently better oxygenation. Because each of these trials had design problems or early termination, prone positioning remains a rescue therapy for patients with acute lung injury or ARDS.

Authors+Show Affiliations

Department of Pulmonary and Critical Care, John Hopkins School of Medicine, Baltimore, Maryland 212187, USA. hfessler@jhmi.eduNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

20040127

Citation

Fessler, Henry E., and Daniel S. Talmor. "Should Prone Positioning Be Routinely Used for Lung Protection During Mechanical Ventilation?" Respiratory Care, vol. 55, no. 1, 2010, pp. 88-99.
Fessler HE, Talmor DS. Should prone positioning be routinely used for lung protection during mechanical ventilation? Respir Care. 2010;55(1):88-99.
Fessler, H. E., & Talmor, D. S. (2010). Should prone positioning be routinely used for lung protection during mechanical ventilation? Respiratory Care, 55(1), 88-99.
Fessler HE, Talmor DS. Should Prone Positioning Be Routinely Used for Lung Protection During Mechanical Ventilation. Respir Care. 2010;55(1):88-99. PubMed PMID: 20040127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Should prone positioning be routinely used for lung protection during mechanical ventilation? AU - Fessler,Henry E, AU - Talmor,Daniel S, PY - 2009/12/31/entrez PY - 2009/12/31/pubmed PY - 2010/3/24/medline SP - 88 EP - 99 JF - Respiratory care JO - Respir Care VL - 55 IS - 1 N2 - Prone positioning has been known for decades to improve oxygenation in animals with acute lung injury and in most patients with acute respiratory distress syndrome (ARDS). The mechanisms of this improvement include a more uniform pleural-pressure gradient, a smaller volume of lung compressed by the heart, and more uniform and better-matched ventilation and perfusion. Prone positioning has an established niche as an intervention to improve gas exchange in patients with severe hypoxemia refractory to standard ventilatory manipulations. Because the lung may be more uniformly recruited and the stress of mechanical ventilation better distributed, prone positioning has also been proposed as a form of lung-protective ventilation. However, several randomized trials have failed to show improvements in clinical outcomes of ARDS patients, other than consistently better oxygenation. Because each of these trials had design problems or early termination, prone positioning remains a rescue therapy for patients with acute lung injury or ARDS. SN - 0020-1324 UR - https://www.unboundmedicine.com/medline/citation/20040127/Should_prone_positioning_be_routinely_used_for_lung_protection_during_mechanical_ventilation L2 - http://rc.rcjournal.com/cgi/pmidlookup?view=short&pmid=20040127 DB - PRIME DP - Unbound Medicine ER -