Critical Care Scenarios TIRBO #47: Why do we prone?
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Nov 1, 2023 Critical care scenarios are discussed in this episode, focusing on the reasons for prone positioning of patients with ARDS. Topics include physiological benefits, lung compliance, even force distribution, lung injury nuances, and debates on proning patients for oxygenation versus protection on ECMO.
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Why Proning Helps in ARDS
- Proning improves outcomes in severe ARDS by redistributing ventilation and perfusion to better match each other.
- Flipping the patient makes the best-ventilated lung dependent, matching it with the best-perfused areas and improving gas exchange.
Proning Distributes Lung Stress
- Prone positioning evens out lung compliance and distributes ventilatory stress more evenly across lung units.
- This reduces localized overdistension and lung injury, promoting lung protection beyond just improving oxygenation.
Additional Benefits of Proning
- Proning also aids secretion clearance by changing tracheal orientation to facilitate drainage.
- It can prevent pressure injuries by offloading anterior body parts during prolonged immobilization.