Critical Care

official impact factor 4.60

Commentary

Positioning of patients with acute respiratory distress syndrome: combining prone and upright makes sense

Jean-Christophe M Richard1* and Jean-Claude Lefebvre1,2

Author Affiliations

1 Hôpitaux universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland

2 Intensive Care Unit, Centre Hospitalier Universitaire de Québec, Québec, Canada

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Critical Care 2011, 15:1019 doi:10.1186/cc10560


See related research by Robak et al., http://ccforum.com/content/15/5/R230

Published: 15 December 2011

Abstract

Positional strategies have been proposed for mechanically ventilated patients with acute respiratory distress syndrome. Despite different physiological mechanisms involved, oxygenation improvement has been demonstrated with both prone and upright positions. In the previous issue of Critical Care, Robak and colleagues reported the first study evaluating the short-term effects of combining prone and upright positioning. The combined positioning enhanced the response rate in terms of oxygenation. Other benefits, such as a reduction in ventilator-associated pneumonia and better enteral feeding tolerance, can potentially be expected.