title: Prone positioning in the patient who has acute respiratory distress syndrome: the art and science.
abstract: Acute respiratory distress syndrome (ARDS) remains a significant contributor to the morbidity and mortality of patients in the ICU. A variety of treatments are used to support the lung of the patient who has ARDS and improve gas exchange during the acute injury phase. It seems, however, that the simple, safe, and noninvasive act of prone positioning of the critically ill patient who has ARDS may improve gas exchange while preventing potential complications of high positive end-expiratory pressure, volutrauma, and oxygen toxicity. This article provides the critical care nurse with the physiologic rationale for use of the prone position, indications and contraindications for use, safe strategies for prone positioning, and care techniques and monitoring methods of the patient who is in the prone position.
authors.affiliation: Advancing Nursing, 23613 Edward, Dearborn, MI 48128, USA. kvollman@comcast.net
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Vollman
mesh_terms: D003422:Critical Care / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D008991:Monitoring, Physiologic; D024802:Nurse's Role; D009730:Nursing Assessment; D010347:Patient Care Planning; D010353:Patient Education as Topic; D018579:Patient Selection; D016684:Prone Position; D011659:Pulmonary Gas Exchange; D012128:Respiratory Distress Syndrome / Q000378:metabolism / Q000401:mortality / Q000451:nursing* / Q000503:physiopathology; D012129:Respiratory Function Tests; D015656:Respiratory Mechanics; D012449:Safety; D015996:Survival Rate; D013997:Time Factors; D014692:Ventilation-Perfusion Ratio