Unregistered User If this is not your name, click here.
		Contact Us | Order Now | Journals | Bookstore | Register a colleague
	Select a ChannelAcneAIDS and HIVAllergy OtherAlzheimer'sAnaesthesiology OtherAngina Pectoris/MIAnxietyArthritis OtherAsthmaBack PainBacterial InfectionsBladder CancerBone Marrow TransplantationBreast CancerCardiology OtherCataractCell TransplantationCervical CancerCholesterol/Lipid disordersCirrhosisClinical PharmacologyColorectal CancerCongestive Heart FailureContact DermatitisContraceptionCOPDCystic FibrosisDental and Oral DisordersDepressionDermatology OtherDiabetesDialysisEating DisordersElbowEmergency MedicineEndocrinology OtherEpilepsyErectile DysfunctionFibromyalgiaGastro OtherGeneticsGenitourinary OtherGeriatricsGERD/GastritisGlaucomaH. Pylori/UlcerHaematology OtherHair LossHeadachesHepa/Biliary OtherHepatitisHipHRTHypertensionIBDImmunologyInfectious OtherInfertilityIntensive CareIrritable Bowel SyndromeKneeLeukemiasLiver CancerLung CancerLupusLymphomasMelanomaMenopauseMultiple Sclerosis Nephrology OtherNeurologic OtherNutritional / Metabolic OtherOb/Gyn OtherObesityOncology OtherOphth. OtherOphthalmic SurgeryOrgan TransplantationOrthopaedics OtherOsteoarthritisOsteoporosisOtitisOtorhino. OtherOvarian CancerPaediatricsPainPancreatic CancerParkinson'sPregnancyProstate CancerPsychiatry OtherPulmonary OtherRadiologyRenal CancerRenal FailureRespiratory InfectionsRheumatoid arthritisRheumatology OtherRhinitisSchizophreniaShoulderSleep ApnoeaSleep DisordersSpineStrokeSTDsSurgeryThyroid DisordersTransfusionTransplant Surgery OtherTraumaUrinary IncontinenceUrinary tract infectionsVaccinologyVascular DisordersViral Infections

SEARCH   News Bookstore Medline The Web Meetings & Congresses Complete Doctor's Guide    EXPLORE :    All News   All Webcasts   All Cases   All Meetings & Congresses   All Medical Resources New drugs / indications English Dictionary Medical Dictionary Thesaurus Warning | Privacy | Awards  Favourite Journals  Click here to choose your favourite journals  Favourite Sites  Click here to choose your favourite sites  Languages  Select languageEnglishFrançais

Prone Position Does Not Provide Survival Benefit for Ventilated Patients With Hypoxemia CHICAGO -- November 10, 2009 -- Despite a current suggestion that patients with acute respiratory distress syndrome (ARDS) be positioned lying face down while receiving mechanical ventilation, study results indicate that this positioning does not significantly lower the risk of death compared with similar patients positioned lying face up during ventilation, according to a study published in the November 11 issue of JAMA. Paolo Taccone, MD, Fondazione IRCCS - Ospedale Maggiore Policlinico, Mangiagalli, Regina Elena di Milano, Milan, Italy, and colleagues conducted a multicentre, randomised, controlled trial to detect the potential survival benefit of prone positioning in patients with moderate and severe hypoxemia who are affected by ARDS. The study included 342 adult patients with ARDS receiving mechanical ventilation, enrolled from February 2004 through June 2008 and stratified into subgroups with moderate (n = 192) and severe (n = 150) hypoxemia. Patients were randomised to undergo supine (lying face up; n = 174) or prone (20 hours per day; n = 168) positioning during ventilation. The researchers found that prone and supine patients from the entire study population had similar 28-day (31.0% vs 32.8%) and 6-month (47.0% vs 52.3%) mortality rates, despite significantly higher complication rates in the prone group. Outcomes were also similar for patients with moderate hypoxemia in the prone and supine groups at 28 days (25.5% vs 22.5%) and at 6 months (42.6% vs 43.9%). The 28-day mortality of patients with severe hypoxemia was 37.8% in the prone and 46.1% in the supine group, while their 6-month mortality was 52.7% and 63.2%, respectively. Median Sequential Organ Failure Assessment (SOFA) scores, ventilator-free days, and intensive care unit length of stay were also similar between the different groups of patients. “Undoubtedly, the data of the present trial together with previous results clearly indicate that prolonged prone positioning, in the unselected ARDS population, is not indicated as a treatment,” the authors wrote. “However, its potential role in patients with the most severe hypoxemia, for whom the possible benefit could outweigh the risk of complications, must be further investigated, considering the strong pathophysiological background, the post hoc result of our previous study, the most recent meta-analysis, and the favourable trend observed prospectively in this study.” SOURCE: JAMA E-mail this page to a friend or colleague! To print, use this version