You are asked to see him later that day by the nurse who is concerned that he is continuing to deteriorate. You feel he may benefit from prone position...
Typical criteria include those used in the PROSEVA trial: PEEP of at least 5 cmH2O with FiO2 of at least 60% required to keep PaO2 over 8kPa Ventilator settings optimized, paralyzed and recruitment manoeuvres attempted Unable to keep peak airway pressure below 30cmH2O...
Improved V/Q matching (probably most important factor) More uniform distribution of ventilation and perfusion Prevents atelectatic bases receiving highest blood flow A relative increase in functional residual capacity Reduction of cephalad pressure on the diaphragm...
RCT: PROSEVAGuerin et alNEJM (2013)View Paper Meta-AnalysisMunshi et alAnnals of ATS (2017)View Paper Intervention Prone ventilation for 16 hours per day for up to 5 days Prone vs. supine position in mechanical ventilation Population 474 patients with moderate to...
