• L Papazian, M H Paladini, F Bregeon, L Huiart, X Thirion, P Saux, Y Jammes, and J P Auffray.
• Service de Réanimation Médicale, Hĵpitaux Sud, Marseille, France. lpapazian@mail.ap-hm.fr
• Intensive Care Med. 2001 Jun 1;27(6):1044-9.

ObjectiveTo determine whether a 1-h trial of prone positioning is sufficient to identify responders.DesignProspective clinical cohort study in a medico-surgical ICU in a teaching hospital.Patients49 patients with acute respiratory distress syndrome.InterventionsA 6-h period of prone positioning.Measurements And ResultsBaseline measurements (blood gas analysis and respiratory parameters) were evaluated in supine position just prior to turning the patients prone. Measurements were then repeated 1 h after the beginning of prone positioning (PP1h) and at the end of the 6-h period of prone positioning (PP6h). The last measurements were performed 1 h after repositioning the patients supine. Prone position induced an increase in the PaO2/FIO2 ratio (p < 0.001). A response (increase in PaO2/FIO2 ratio of at least 20 % at PP1h and/or at PP6h) was observed in 37 of 49 patients (76%). Twenty-seven of these patients (73%) were responders at PP1h while 10 (27%) were responders only at PP6h- In all, two-thirds of the patients were considered persistent responders. However, whereas the PaO2/FIO2 ratio decreased significantly 1 h after repositioning the fast responders supine, the PaO2/ FIO2 ratio remained unchanged after repositioning slow responders.ConclusionsA short-term trial of prone positioning does not appear a sufficient method to identify patients who would benefit from the postural treatment.

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