• Erwan L'Her, Anne Renault, Emmanuel Oger, Marie-Aline Robaux, and Jean-Michel Boles.
• Réanimation et Urgences Médicales, CHU de la Cavale Blanche, Bvd Tanguy-Prigent, 29609 Brest Cedex, France. elher@univ-brest.fr
• Intensive Care Med. 2002 May 1; 28 (5): 570-5.

ObjectivesTo evaluate of the oxygenation effects of 12-h prone positioning (PP) in ARDS patients and to assess the safety of such a procedure.Design And SettingProspective observational study in a medical intensive care unit (12 beds) of a university hospital.Patients51 consecutive ARDS patients.InterventionPP for at least 12 h daily until recovery or death.Measurements And ResultsArterial blood gases were collected before and during PP and 1 h after return to supine. Turning adverse events, cutaneous bedsores, and enteral nutrition intolerance were specifically monitored and collected daily by a referring physician. In total 224 PP sessions were performed. Oxygenation improved 1 h after the turn and continued improving over the 12-h period (4). The beneficial effect persisted 1 h after return to supine (01). We considered 96% patients responders: 45% as early responders and 53% persistent responders (persistent benefit after return to supine). Four significant adverse events occurred during the 448 turning maneuvers (0.9%). Stage III ulceration and stage IV necrosis cutaneous bedsores occurred in ten patients (20%). Enteral nutrition intolerance was reported in 25% but without inability to meet patient's caloric requirement.ConclusionsTwelve-hour PP is a safe procedure and allows a continuous oxygenation improvement throughout the entire session.

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