title: Improved oxygenation using the prone position in patients with ARDS.
abstract: BACKGROUND
  The prone position is known to increase oxygen uptake in patients with Adult Respiratory Distress Syndrome (ARDS).
  
  
  METHODS
  In this clinical study from 1995-96, 14 ARDS patients with severe respiratory failure were treated for at least 1 h in the prone position. Responders, defined as having more than 10% increase in PaO2/FiO2 ratio from baseline after 1 h, were treated at least 6 h in the prone position.
  
  
  RESULTS
  11 patients responded during the first period of the prone position (primary responders). Two of the 3 non-responders were turned prone a second time with increase in the PaO2/FiO2 ratio (secondary responders). Mean PaO2/FiO2 ratio (mean +/- SEM) in the supine position was 11.7 +/- 0.8 kPa, increasing to 16.6 +/- 1.8 kPa and 18.0 +/- 1.4 kPa after 1 and 6 h respectively (P = 0.009). Mean time spent in the prone position was 69 h (range 3-256 h), and mean ventilatory time was 17 d (3-52 d). The mortality in this subgroup of our patients with ARDS was 42%, compared to 58% in 19 patients not turned prone in the same period.
  
  
  CONCLUSIONS
  The prone position together with PEEP appears to improve ventilation-perfusion matching. The prone position is simple, effective and readily available and could be used early in most patients with ARDS.
authors.affiliation: Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
authors.forename: H
authors.initials: H
authors.lastname: Flaatten
authors.forename: S
authors.initials: S
authors.lastname: Aardal
authors.forename: O
authors.initials: O
authors.lastname: Hevrøy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D016684:Prone Position; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000628:therapy*
chemical_list: D010100:Oxygen