Prone Position Helps Patients with Acute Lung Injury

A study has shown that critical care patients with acute lung injury or acute respiratory syndrome (ALI/ARDS) who showed improved respiratory gas exchange when placed in a prone position have an increased survival rate. The study was published in the December 2003 issue of Critical Care Medicine.

Researchers studied 225 ICU patients with ALI/ARDS to evaluate the association between improved respiratory gas exchange in the prone position and patient outcome. The patients meeting ALI/ARDS criteria were then positioned on their stomachs for six hours a day for 10 days. Those patients who responded positively to proning with reduced PaCO2 (arterial partial pressure) levels had a mortality rate of 35.1%, and those who did not respond to proning had a mortality rate of 52.2%. Improved respiratory efficiency is an important marker for surviving respiratory failure, the researchers note.

"This research underlies the importance of considering carbon dioxide clearance together with oxygenation,” said lead author Luciano Gattinoni, M.D., professor at the Istituto di Anestesia e Rianimazione, Universita degli Studi di Milano (Italy; www.unimi.it). Carbon dioxide changes, more so than oxygen changes, he noted, relate to the anatomic status of the lung.




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