Size Inclusive Care

By Allison Varnum

Approximately 93 million Americans are affected by obesity¹. How many of your patients are living with obesity? Caring for the patient with obesity can present challenges, but every patient regardless of size should have access to the same standard of care.

Obesity has been shown to contribute to a greater risk of developing acute respiratory distress syndrome (ARDS) and pneumonia². It also increases the ICU length of stay and time on the mechanical ventilator. Patients of size also have increased work of breathing because of tissue displacement in the abdomen and chest as well as increased airway resistance due to smaller airway dimensions and increased asthma occurrence. Obese patients’ functional residual capacity (FRC) is decreased by up to 21% in the supine position along with a decrease in total lung and vital capacity which can cause atelectasis².

Prone positioning is used to improve oxygenation in patients with respiratory illnesses such as ARDS, but proning patients of size can be a challenge. However, shouldn’t all patients, regardless of size, have access to the same standard of care? The PROSEVA study showed that prone positioning reduces mortality in patients with ARDS³. When proning a patient with obesity, it is important to note that the safety and efficiency of pronation did not significantly differ from pronation in patients without obesity. In fact, the PaO2/FiO2 (P/F) ratio improved more in patients with obesity in the prone position than in patients without obesity².  

When we at Turn Medical designed the Pronova-O2^TM Automated Prone Therapy System, we accommodated patients weighing up to 400 pounds. Automated proning takes the manual labor out of positioning patients and therefore allows a more diverse population of patients to be proned. When proning a patient with obesity, it is important to avoid increased intra-abdominal pressure and organ compression². The Pronova-O2^TM was developed with an open abdominal area and allows securing the abdomen with a flexible sling. This sling allows for the abdomen to drop while still fully secured therefore omitting an increase in intra-abdominal pressure in the prone position. By addressing some of these issues in pronation for the obese patient, we at Turn Medical hope to improve care for patients. Patients of all sizes deserve to be treated with the standard of care.

Visit turnmedical.com or call us at 855-ASK-TURN to learn more about our products and services. Turn Medical is committed to delivering innovative solutions to address unmet needs in the acute care environment in order to deliver superior patient outcomes.