Safety of prone positioning in critically ill patients

摘要

During the past two years, 5% of patients admitted to the Medical Intensive Care Unit (MICU) of Hamad General Hospital (HGH) had severe acute respiratory distress syndrome (ARDS) with a PaO /FiO ratio less than 100 mmHg. The risks associated with this condition include ventilator associated lung injury, over distension of lungs, and poor gas exchange which results in increased morbidity and mortality. With quality improvement initiatives like prone positioning, the mortality and morbidity associated with severe acute respiratory syndrome can be reduced by improving hypoxemia with a significant enhancement in PaO /FiO ratios while reducing injurious ventilation. Also, prone positioning can help prevent invasive interventions such as placing patients on extracorporeal membrane oxygenation (ECMO) therapy. We evaluated the safety of prone positioning for improving hypoxemia in critically ill patients with PaO /FiO ratio 2/FiO ratio st January 2017 to 31 December 2018, without major complications. Data collected included the PaO /FiO ratios based on arterial blood gases of mechanically ventilated patients before and after prone positioning.