Prone Positioning Improves Oxygenation in Post-traumatic Lung Injury-A Prospective Randomized Trial

摘要

In 1974, Bryan was the first to suggest prone positioning in patients with severe ARDS to improve gas exchange.1 Based on numerous studies indicating an improvement of gas exchange, prone positioning was increasingly used in the last decade. Prone positioning results in recruitment of alveoli,2 a more uniform regional ventilation-perfusion relationship,3"5 and therefore, an improvement of gas exchange6"8 as a result of postural differences in chest wall mechanics9 and eliminated compression of the lungs by the heart.In a non-randomized study published recently, intermittent prone positioning improved pulmonary gas exchange significantly in multiple trauma patients with severe ARDS, as well as in patients with moderate lung injury.