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Open Access 01-10-2011 | Research

Short-term effects of combining upright and prone positions in patients with ARDS: a prospective randomized study

Authors: Oliver Robak, Peter Schellongowski, Andja Bojic, Klaus Laczika, Gottfried J Locker, Thomas Staudinger

Published in: Critical Care | Issue 5/2011

Abstract

Introduction

Prone position is known to improve oxygenation in patients with acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS). Supine upright (semirecumbent) position also exerts beneficial effects on gas exchange in this group of patients. We evaluated the effect of combining upright and prone position on oxygenation and respiratory mechanics in patients with ALI or ARDS in a prospective randomized cross-over study.

Methods

After turning them prone from a supine position, we randomized the patients to a prone position or combined prone and upright position. After 2 hours, the position was changed to the other one for another 6 hours. The gas exchange and static compliance of the respiratory system, lungs, and chest wall were assessed in the supine position as well as every hour in the prone position.

Results

Twenty patients were enrolled in the study. The PaO₂/FiO₂ ratio improved significantly from the supine to the prone position and further significantly increased with additional upright position. Fourteen (70%) patients were classified as responders to the prone position, whereas 17 (85%) patients responded to the prone plus upright position compared with the supine position (P = n.s.). No statistically significant changes were found with respect to compliance.

Conclusions

Combining the prone position with the upright position in patients with ALI or ARDS leads to further improvement of oxygenation.

Trial registration

Clinical Trials No. NCT00753129

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Title: Short-term effects of combining upright and prone positions in patients with ARDS: a prospective randomized study
Authors: Oliver Robak
Peter Schellongowski
Andja Bojic
Klaus Laczika
Gottfried J Locker
Thomas Staudinger
Publication date: 01-10-2011
Publisher: BioMed Central
Published in: Critical Care / Issue 5/2011
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc10471

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Short-term effects of combining upright and prone positions in patients with ARDS: a prospective randomized study

Abstract

Introduction

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Trial registration

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