Prone Positioning in ARDS Patients

Recommendations for Prone Positioning

The American Thoracic Society and other major guidelines recommend maintaining prone position for 12-18 hours per day for therapeutic benefit in ARDS patients 1, 2, 3
Daily prone positioning sessions are recommended until oxygenation improves, defined as PaO2/FiO2 ≥150 with PEEP ≤10 cmH2O and FiO2 ≤0.6 1, 2
The Society of Critical Care Medicine emphasizes the importance of optimizing volume status prior to prone positioning 1, 2
Ongoing vasopressor therapy is not a contraindication for prone positioning, according to the European Society of Intensive Care Medicine 1, 2
The prone positioning maneuver is considered hemodynamically well tolerated by the American College of Chest Physicians 1, 2
Delaying prone positioning while attempting to gather additional staff or equipment should be avoided, and the procedure should be started immediately after indication is established, as recommended by the European Society of Intensive Care Medicine 1, 2
Inadequate preparation of equipment and monitoring before initiating the turn should be avoided, as emphasized by the American Thoracic Society 1, 2
Failure to optimize hemodynamics prior to positioning should be avoided, though the procedure itself is well-tolerated, according to the Society of Critical Care Medicine 1, 2