A group of 15 patients with acute respiratory distress syndrome (ARDS) who had not responded to positive end-expiratory pressure adjustment were treated with extended prone position ventilation (PPV).
Two patients developed grade II pressure ulcers of small extent. None of the patients experienced life-threatening complications or hemodynamic instability during the procedure. The patients showed a statistically significant improvement in PaO2/FiO2 and oxygenation index, reduction of PaCO2 and plateau pressure, and increment of the static compliance with extended PPV. Continued improvement in all parameters occurred while the patients remained prone and did not change upon returning the patients to the supine position. These results suggest that extended PPV is safe and effective in patients with severe ARDS when it is carried out by a trained staff and within an established protocol.
Journal of Critical Care 2009; 24: 81 â€“ 88