The DOI matches its Crossref record; 71 of the 71 references it cites were found in a registry or an index.
Prone Position in Acute Respiratory Distress Syndrome. Rationale, Indications, and Limits
Abstract
In the prone position, computed tomography scan densities redistribute from dorsal to ventral as the dorsal region tends to reexpand while the ventral zone tends to collapse. Although gravitational influence is similar in both positions, dorsal recruitment usually prevails over ventral derecruitment, because of the need for the lung and its confining chest wall to conform to the same volume. The final result of proning is that the overall lung inflation is more homogeneous from dorsal to ventral than in the supine position, with more homogeneously distributed stress and strain. As the distribution of perfusion remains nearly constant in both postures, proning usually improves oxygenation. Animal experiments clearly show that prone positioning delays or prevents ventilation-induced lung injury, likely due in large part to more homogeneously distributed stress and strain. Over the last 15 years, five major trials have been conducted to compare the prone and supine positions in acute respiratory distress syndrome, regarding survival advantage. The sequence of trials enrolled patients who were progressively more hypoxemic; exposure to the prone position was extended from 8 to 17 hours/day, and lung-protective ventilation was more rigorously applied. Single-patient and meta-analyses drawing from the four major trials showed significant survival benefit in patients with PaO2/FiO2 lower than 100. The latest PROSEVA (Proning Severe ARDS Patients) trial confirmed these benefits in a formal randomized study. The bulk of data indicates that in severe acute respiratory distress syndrome, carefully performed prone positioning offers an absolute survival advantage of 10-17%, making this intervention highly recommended in this specific population subset.
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Citations
Cites
(2000) · New England Journal of Medicine · doi:10.1056/nejm200005043421801 · Cited by 12,941
Acute Respiratory Distress Syndrome: The Berlin Definition
(2012) · JAMA · doi:10.1001/jama.2012.5669 · Cited by 8,731
Prone positioning in severe acute respiratory distress syndrome.
Guérin, C., Reignier, J., Richard, J.-C., Beuret, P., Gacouin, A., Boulain, T., Mercier, E., Badet, M., Mercat, A., Baudin, O., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1214103 · Cited by 4,040
Neuromuscular Blockers in Early Acute Respiratory Distress Syndrome
Papazian, L., Forel, J.-M., Gacouin, A., Penot-Ragon, C., Perrin, G., Loundou, A., Jaber, S., Arnal, J.-M., Perez, D., Seghboyan, J.-M., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1005372 · Cited by 2,432
Ventilator-induced Lung Injury: Lessons from Experimental Studies
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Lung recruitment in patients with the acute respiratory distress syndrome.
Gattinoni, L., Caironi, P., Cressoni, M., Chiumello, D., Ranieri, V. M., Quintel, M., Russo, S., Patroniti, N., Cornejo, R., & Bugedo, G. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa052052 · Cited by 1,548
Self-citationStress distribution in lungs: a model of pulmonary elasticity.
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Cited by
Acute respiratory distress syndrome
Matthay, M. A., Zemans, R. L., Zimmerman, G. A., Arabi, Y. M., Beitler, J. R., Mercat, A., Herridge, M., Randolph, A. G., & Calfee, C. S. (2019) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0069-0 · Cited by 2,387
Prone position in ARDS patients: why, when, how and for whom
Guérin, C., Albert, R. K., Beitler, J., Gattinoni, L., Jaber, S., Marini, J. J., Munshi, L., Papazian, L., Pesenti, A., Vieillard-Baron, A., et al. (2020) · Intensive Care Medicine · doi:10.1007/s00134-020-06306-w · Cited by 532
Self-citationStawicki, S., Jeanmonod, R., Miller, A., Paladino, L., Gaieski, D., Yaffee, A., De Wulf, A., Grover, J., Papadimos, T., Bloem, C., et al. (2020) · Journal of Global Infectious Diseases · doi:10.4103/jgid.jgid_86_20 · Cited by 373
Treatment of ARDS With Prone Positioning
Scholten, E. L., Beitler, J. R., Prisk, G. K., & Malhotra, A. (2017) · Chest · doi:10.1016/j.chest.2016.06.032 · Cited by 365
Acute Lung Injury – From Pathophysiology to Treatment
Mokra, D. (2021) · Physiological Research · doi:10.33549/physiolres.934602 · Cited by 293
Metadata
- Authors
- Gattinoni, L., Taccone, P., Carlesso, E., & Marini, J. J.
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-12-01
- Volume
- 188
- Issue
- 11
- Pages
- 1286-1293
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2101877480
- Cited by
- 488
- References
- 71
- FWCI
- 16.81
- Type
- journal article
- Language
- en
- Open access
- closed
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- Gattinoni, L., Taccone, P., Carlesso, E., & Marini, J. J. (2013). Prone Position in Acute Respiratory Distress Syndrome. Rationale, Indications, and Limits. American Journal of Respiratory and Critical Care Medicine. https://doi.org/10.1164/rccm.201308-1532ci
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
