A multicenter trial of prolonged prone ventilation in severe acute respiratory distress syndrome.

@article{Mancebo2006AMT,
  title={A multicenter trial of prolonged prone ventilation in severe acute respiratory distress syndrome.},
  author={Jordi Mancebo and Rafael Fernandez and Llu{\'i}s Blanch and Gemma Rialp and Federico Gordo and Miquel Ferrer and Fernando Rodr{\'i}guez and Pau Garro and Pilar Ricart and Immaculada Vallverd{\'u} and Ignasi J Gich and Jos{\'e} Casta{\~n}o and Pilar Saura and Guillermo Dom{\'i}nguez and Alfonso Bonet and Richard K. Albert},
  journal={American journal of respiratory and critical care medicine},
  year={2006},
  volume={173 11},
  pages={
          1233-9
        }
}
RATIONALE Ventilation in the prone position for about 7 h/d in patients with acute respiratory distress syndrome (ARDS), acute lung injury, or acute respiratory failure does not decrease mortality. Whether it is beneficial to administer prone ventilation early, and for longer periods of time, is unknown. METHODS We enrolled 136 patients within 48 h of tracheal intubation for severe ARDS, 60 randomized to supine and 76 to prone ventilation. Guidelines were established for ventilator settings… 
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Prone ventilation in acute respiratory distress syndrome
  • C. Guérin
  • Medicine
    European Respiratory Review
  • 2014
TLDR
From the currently available data, prone positioning should be used as a first-line therapy in patients with severe ALI/ARDS and the limitations of its use as well as the current place of prone positioning in the management of patients with ALI.
The effects of prone position ventilation in patients with acute respiratory distress syndrome. A systematic review and metaanalysis.
Prone positioning in acute respiratory distress syndrome: a multicenter randomized clinical trial
TLDR
Data added to this study adds data that reinforce the suggestion of a beneficial effect of early continuous prone positioning on survival in ARDS patients, and helps clarify the role of protective ventilation in the treatment of prone patients.
Prone positioning in severe acute respiratory distress syndrome.
TLDR
In patients with severe ARDS, early application of prolonged prone-positioning sessions significantly decreased 28-day and 90-day mortality.
Prone positioning in patients with moderate and severe acute respiratory distress syndrome: a randomized controlled trial.
TLDR
Data from this study indicate that prone positioning does not provide significant survival benefit in patients with ARDS or in subgroups of patients with moderate and severe hypoxemia.
Prone positioning ventilation for treatment of acute lung injury and acute respiratory distress syndrome.
TLDR
Based on current data, a trial of prone positioning ventilation should be offered to the patients who have ALI/ARDS in the early course of the disease, with the aim of improving oxygenation without use of expensive, invasive and experimental procedures.
Extended prone position ventilation in severe acute respiratory distress syndrome: a pilot feasibility study.
Clinical Meaning of Early Oxygenation Improvement in Severe Acute Respiratory Distress Syndrome under Prolonged Prone Positioning
TLDR
The results suggest that the early oxygenation improvement after prone positioning might be associated with an improved 28-day outcome and may be an indicator to maintain prolonged prone positioning in patients with severe ARDS.
Effectiveness of Prone Ventilation in patients with Acute Respiratory Distress Syndrome: a systematic review
TLDR
The effectiveness of prone positioning in critically ill adult patients requiring mechanical ventilation due to Acute Respiratory Distress Syndrome on mortality, oxygenation and duration of mechanical ventilation is identified.
Prone ventilation as treatment of acute respiratory distress syndrome related to COVID-19
TLDR
The physiological principles and effects of the prone ventilation, positioning, as well as its contraindications and complications are reviewed.
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References

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Effects of systematic prone positioning in hypoxemic acute respiratory failure: a randomized controlled trial.
TLDR
This trial demonstrated no beneficial outcomes and some safety concerns associated with prone positioning, but for patients with hypoxemic ARF, prone position placement may lower the incidence of VAP.
Short-term effects of prone position in critically ill patients with acute respiratory distress syndrome
TLDR
The data suggest that prone positioning should be carried out early in the course of ARDS, and that turning critically ill, severely hypoxemic patients from the supine to the prone position is a safe and useful therapeutic intervention.
EFFECT OF PRONE POSITIONING ON THE SURVIVAL OF PATIENTS WITH ACUTE RESPIRATORY FAILURE
TLDR
Although placing patients with acute respiratory failure in a prone position improves their oxygenation, it does not improve survival.
Improvement in oxygenation by prone position and nitric oxide in patients with acute respiratory distress syndrome
TLDR
In patients with the acute respiratory distress syndrome, the combination of NO and prone position is a valuable adjunct to mechanical ventilation.
Effect of prone positioning on clinical outcomes in children with acute lung injury: a randomized controlled trial.
TLDR
Prone positioning does not significantly reduce ventilator-free days or improve other clinical outcomes in pediatric patients with acute lung injury.
Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial.
TLDR
Mechanical ventilation can induce a cytokine response that may be attenuated by a strategy to minimize overdistention and recruitment/derecruitment of the lung and whether these physiological improvements are associated with improvements in clinical end points should be determined.
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TLDR
It is concluded that no benefit could be observed with reduced VT titrated to reach plateau pressures around 25 cm H2O compared with a more conventional approach in which normocapnia was achieved with plateau pressures already below 35 cm H 2O.
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TLDR
Patients with severe acute respiratory failure, unrelated to left ventricular failure to atelectasis, were turned to and from a supine to prone position at 1- and 4-h intervals to characterize changes in oxygenation.
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TLDR
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TLDR
It is concluded that high-frequency oscillation is a safe and effective mode of ventilation for the treatment of acute respiratory distress syndrome in adults.
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