Prone positioning in acute respiratory distress syndrome

Nurs Stand. 2015 Aug 12;29(50):34-9. doi: 10.7748/ns.29.50.34.e9261.

Abstract

Acute respiratory distress syndrome (ARDS) is a condition with a high morbidity and mortality rate, and treatment is often long and costly. Prone positioning is a rarely used intervention for patients with this syndrome, although research suggests it may be effective. A literature search was undertaken to examine the effects of prone positioning on oxygenation, morbidity and mortality in patients with ARDS. It revealed that prone positioning, when used with low tidal volume ventilation over an extended period, may reduce mortality rates in selected patients with severe ARDS. The selection of patients with severe ARDS for prone positioning should be done on a case-by-case basis to maximise benefits and minimise complications. Further research is required on the use of prone positioning in patients with severe ARDS to support or disclaim the therapy's use in practice, and to compare confounding variables such as ideal prone duration and mechanical versus manual pronation.

Keywords: ARDS; Acute respiratory distress syndrome; effectiveness of prone positioning; prone; prone position; prone therapy; respiratory failure.

Publication types

  • Review

MeSH terms

  • Female
  • Humans
  • Male
  • Prone Position
  • Respiratory Distress Syndrome / mortality
  • Respiratory Distress Syndrome / physiopathology*
  • Respiratory Distress Syndrome / therapy*