title: Prone positioning for acute respiratory distress syndrome.
abstract: Multiple animal and human studies have shown that prone positioning improves oxygenation and reduces ventilator-induced lung injury (VILI) in the setting of acute lung injury or acute respiratory distress syndrome (ARDS). In this article, the physiologic changes explaining the improvement in oxygenation are reviewed, how prone positioning reduces VILI is described, randomized controlled trials of prone ventilation in patients with ARDS are evaluated, the complications associated with prone ventilation are summarized, suggestions are made as to how these might be reduced or avoided, and when prone ventilation should start and stop and for what duration it should be used are discussed.
authors.affiliation: University of Colorado, 12605 E, 16th avenue, Aurora, CO 80045, USA; Department of Medicine, Denver Health, 777 Bannock, MC 4000, Denver, CO 80204-4507, USA.
authors.forename: Alexander B
authors.initials: AB
authors.lastname: Benson
authors.affiliation: University of Colorado, 12605 E, 16th avenue, Aurora, CO 80045, USA; Department of Medicine, Denver Health, 777 Bannock, MC 4000, Denver, CO 80204-4507, USA. Electronic address: ralbert@dhha.org.
authors.forename: Richard K
authors.initials: RK
authors.lastname: Albert
mesh_terms: D003422:Critical Care; D006801:Humans; D016684:Prone Position; D012128:Respiratory Distress Syndrome / Q000503:physiopathology*
keywords: Acute respiratory distress syndrome; Hypoxemia; Prone position; Ventilator-induced lung injury