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Prone Position

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Acute Respiratory Distress Syndrome

Abstract

Prone positioning, i.e., installing the patient face down in the bed while receiving mechanical ventilation, is an old technique that has been used for many years to successfully improve oxygenation in ARDS patients. It has proven benefit to improve survival in patients with ARDS and severity criteria based on oxygenation in a single randomized controlled trial, which has confirmed previous meta-analyses.

This beneficial effect on patient outcome likely stems from prevention of ventilator-induced lung injury and preservation of hemodynamics. It should be used early in the course of ARDS, in patients with severe oxygenation impairment. It should not be seen as a rescue intervention, even though it can be used as such in case of refractory hypoxemia.

This chapter summarizes the physiological effects of proning on oxygenation and lung protection, the clinical effects on mortality and the presumed mechanisms by which this effect may result from, and the application of this technique in the clinical practice.

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Authors and Affiliations

  1. Service de Réanimation Médicale, Hôpital de la Croix Rousse, Lyon, France

    Claude Guérin

  2. Université de Lyon, Lyon, France

    Claude Guérin

  3. IMRB INSERM, 955 Equipe 13, Créteil, France

    Claude Guérin

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  1. Claude Guérin
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Correspondence to Claude Guérin .

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  1. Department of "Scienze della Salute", University of Milan, Director of Anaesthesia and Intensive Care Services , ASST Santi Paolo e Carlo, Milan, Italy

    Davide Chiumello

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Guérin, C. (2017). Prone Position. In: Chiumello, D. (eds) Acute Respiratory Distress Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-319-41852-0_6

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  • DOI: https://doi.org/10.1007/978-3-319-41852-0_6

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