Prone Positioning in Severe Acute Respiratory Distress Syndrome
Prone Positioning in Severe Acute Respiratory Distress Syndrome
Previous trials involving patients with the acute respiratory distress syndrome (ARDS) have failed to show a beneficial effect of prone positioning during mechanical ventilatory support on outcomes. We evaluated the effect of early application of prone positioning on outcomes in patients with severe ARDS. A total of 237 patients were assigned to the prone group, and 229 patients were assigned to the supine group. The 28-day mortality was 16.0% in the prone group and 32.8% in the supine group (P<0.001). The hazard ratio for death with prone positioning was 0.39 (95% confidence interval [CI], 0.25 to 0.63). Unadjusted 90-day mortality was 23.6% in the prone group versus 41.0% in the supine group (P<0.001), with a hazard ratio of 0.44 (95% CI, 0.29 to 0.67). The incidence of complications did not differ significantly between the groups, except for the incidence of cardiac arrests, which was higher in the supine group.
CITATION: Guerin, Claude [etal]. Prone Positioning in Severe Acute Respiratory Distress Syndrome . : New England Journal of Medicine , 2013. The New England Journal of Medicine, Vol. 368, No. 23, June 6, 2013, pp. 2159-2168 - Available at: https://library.au.int/prone-positioning-severe-acute-respiratory-distress-syndrome-4