Editorials

The prone position in acute respiratory distress syndrome

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7035.860 (Published 06 April 1996) Cite this as: BMJ 1996;312:860
  1. Dw Ryan,
  2. P Pelosi
  1. Research fellow University of Milan, 20122, Italy
  2. Director of intensive therapy Freeman Hospital, Newcastle Upon Tyne NE7 7DN

    Small studies have shown that it improves oxygenation

    Acute respiratory distress syndrome (ARDS) is characterised by radiographic diffuse bilateral infiltrates, decreased respiratory compliance, small lung volumes, and severe hypoxia.1 Correcting life threatening hypoxia is one of the main goals of treatment, and a range of possible approaches has been suggested, including high airway pressures, jet ventilation, nitric oxide inhalation, and extracorporeal membrane oxygenation. However, no approach has yet proved definitive. Small case series have shown that the simple expedient of turning a mechanically ventilated patient with life threatening hypoxia to the prone position can bring dramatic improvements in oxygenation.2 This manoeuvre may help to reduce some of the factors believed to damage the lungs of patients with acute respiratory distress syndrome, such as excessive inspiratory pressure and a high inspired oxygen fraction. Is the prone position really beneficial or just another good idea that cannot be proved?

    Using the prone position …

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