title: A prospective survey of early 12-h prone positioning effects in patients with the acute respiratory distress syndrome.
abstract: OBJECTIVE
  To evaluate of the oxygenation effects of 12-h prone positioning (PP) in ARDS patients and to assess the safety of such a procedure.
  
  
  METHODS
  Prospective observational study in a medical intensive care unit (12 beds) of a university hospital.
  
  
  METHODS
  51 consecutive ARDS patients.
  
  
  METHODS
  PP for at least 12 h daily until recovery or death.
  
  
  RESULTS
  Arterial blood gases were collected before and during PP and 1 h after return to supine. Turning adverse events, cutaneous bedsores, and enteral nutrition intolerance were specifically monitored and collected daily by a referring physician. In total 224 PP sessions were performed. Oxygenation improved 1 h after the turn and continued improving over the 12-h period (4). The beneficial effect persisted 1 h after return to supine (01). We considered 96% patients responders: 45% as early responders and 53% persistent responders (persistent benefit after return to supine). Four significant adverse events occurred during the 448 turning maneuvers (0.9%). Stage III ulceration and stage IV necrosis cutaneous bedsores occurred in ten patients (20%). Enteral nutrition intolerance was reported in 25% but without inability to meet patient's caloric requirement.
  
  
  CONCLUSIONS
  Twelve-hour PP is a safe procedure and allows a continuous oxygenation improvement throughout the entire session.
authors.affiliation: Réanimation et Urgences Médicales, CHU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France. elher@univ-brest.fr
authors.forename: Erwan
authors.initials: E
authors.lastname: L'Her
authors.forename: Anne
authors.initials: A
authors.lastname: Renault
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Oger
authors.forename: Marie-Aline
authors.initials: MA
authors.lastname: Robaux
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Boles
mesh_terms: D001784:Blood Gas Analysis; D005260:Female; D006801:Humans; D008297:Male; D016684:Prone Position; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000628:therapy*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D012122:Ventilators, Mechanical / Q000009:adverse effects