Prone Positioning ARDS Patients: from Theory to Practice

Abstract

Prone position is a key component of mechanical ventilation management in patients with a moderate to severe acute respiratory distress syndrome (ARDS). It has important physiological benefits as it significantly improves oxygenation and prevents ventilator-induced lung injury. Prone positioning promotes alveolar recruitment in dependent lung regions and makes the distribution of lung stress and strain more homogeneous, both of which contribute in prevention of ventilator-induced lung injury. It is a key component in the management of ARDS patients in selected cases as it has been shown improving patient’s outcome in a meta-analysis and in a further single trial. It should be noted that proning sessions has to be performed by skilled nursing teams, who should be well trained and know how to follow a standardized procedure.