Prone Therapy and Trauma Article Review

In 2023, the BMC Pulmonary Medicine Journal published the study1, “Effects of Prone Positioning on ARDS Outcomes of Trauma and Surgical Patients: A Systematic Review and Meta-Analysis.” 

This article addressed the limited amount of data on prone positioning for trauma and surgical patients. Prone positioning is a well-known therapy for patients with acute respiratory distress syndrome (ARDS), but because trauma and surgical patients may have additional complications with position changes, this article reviews the benefits and risks of proning this patient population. 

The authors included studies that looked at proning trauma/surgical patients with ARDS. The outcome measures they used were P/F ratio, mortality, ICU length of stay and mechanical ventilator days. They included fifteen studies in their systematic review which consisted of postoperative abdominal surgery patients, postoperative cardiothoracic surgery patients, trauma patients, mixed postoperative and trauma patients, and burn patients that were placed in the prone position from 4 to 18 hours. 

Their results showed patients placed in the prone position had a notably improved P/F ratio compared to those who were left in the supine position. There was also a significant improvement in the mortality rate of those placed in the prone position. Even though there was no notable difference in the length of ICU stay, those in the prone position had fewer mechanical ventilator days. The review also showed that surgical wound complications in the prone patients were no greater than those of patients in the supine position. 

The limitations of this meta-analysis are as follows: clinical and methodologic heterogeneity among the reviewed studies and inability to assess ARDS severity. Because of the positive results of proning trauma and surgical patients, the authors suggest that a large multicenter prospective study is needed.  

The Pronova-O2TM Automated Prone Therapy System provides a safe and efficient method for positioning critically ill patients in the prone position. For additional information on automated prone positioning, please visit turnmedical.com or call 1-855-275-8876.