Patient Proning Resources

Proning patients with Acute Respiratory Distress Syndrome may increase oxygenation and reduce mortality, but the practice is difficult to perform manually. 

Large prospective, randomized trial shows prone therapy improved survival in patients with ARDS or hypoxemia​

DATA FROM CLINICAL STUDY: “Prone Positioning in Severe Acute Respiratory Distress Syndrome”. C Guerin et al. N Engl J Med 2013; 368: 2159-2169​

  • 466 patient multicenter, prospective, randomized control trial over a 28 day horizon – and extrapolated to 90 days​
  • Recruited patients all presented with severe ARDS:  PaO2:FiO2 ratio <150mm Hg, with FiO2 >= 0.6, PEEP of >= 5cm water and tidal volume of 6 mL/kg of predicted body weight​
  • Prone therapy summary:  Avg. 4+/-4 sessions per patient; Avg. 17+/-3 hours per prone session​

Prone vs. supine patient mortality

Mortality of prone patients @ day 28 was significantly lower (16%) than supine group (P<0.001)

graph showing Kaplan-Meier plot of patients in proning and supine position
Kaplan-Meier Plot of the Probability of Survival from Randomization to Day 90.

Prone vs supine PaO2/FiO2

PaO2/FiO2 ratio improved during prone therapy sessions.

graph showing improvement during prone therapy
Mean values of PAO2/FiO2 (mm Hg) in the Prone Position group during the first five sessions (S1: n=170; S2: n=130; S3: n=99; S4: n=71; S5: n=51) (M1 = supine just before proning; M2 = one hour after proning; M3 = end of proning just before going back into the supine position; M4 = 4 hours after supine positioning)