The role of prone positioning in trauma patients
By Allison Varnum
Summer weather is finally here, and people are beginning their summer adventures! It is the season for outdoor activities and subsequently trauma. There is a positive correlation between the summer season and trauma admissions1. Trauma is the leading cause of death in people ages 45 and younger and the fourth leading cause of death in all ages in the United States2. Trauma patients often require massive blood transfusions which can lead to transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) therefore resulting in acute respiratory distress syndrome (ARDS)3. Traumatic injury is the third leading cause of ARDS4.
There is an abundance of studies on ARDS and the benefits of prone positioning for these patients. A meta-analysis published in 2023 reviewed prone positioning in surgical and trauma patients and published favorable outcomes. Upon placing this patient population in the prone position, the number of ventilator days and the mortality rate decreased. Furthermore, the surgical complications in the prone position were not significantly different that those in the supine position5.
Turn Medical developed the Pronova-O2TM with the input of critical care nurses to address the need for an easier and safer way to provide prone therapy to patients. It is our goal to partner with healthcare professionals to turn patients toward positive outcomes.
- Pape-Kohler, C.I., Simanski, C., Nienaber, U., Lefering, R. (2014). External factors and the incidence of severe trauma: time, date, season and moon. Injury, 45(3), S93-S99. https://doi.org/10.1016/j.injury.2014.08.027.
- The American Association for the Surgery of Trauma (2024, May 13). Trauma Facts. https://www.aast.org/resources/trauma-facts#:~:text=Trauma%20is%20the%20leading%20cause,each%20year%20in%20the%20US.
- Roubinian N. TACO and TRALI: biology, risk factors, and prevention strategies. Hematology Am Soc Hematol Educ Program. 2018 Nov 30;2018(1):585-594. doi: 10.1182/asheducation-2018.1.585. Epub 2018 Dec 14. PMID: 30570487; PMCID: PMC6324877.
- Kasotakis, G., Stanfield, B., Haines, K., Vatsaas, C., Alger, A., Vaslef, S.N., Brooks, K., Agarwal, S. (2021). Acute respiratory distress syndrome (ARDS) after trauma: improving incidence but increasing mortality. Journal of Critical Care, 64, 213-218. https://doi.org/10.1016/j.jcrc.2021.05.003
- Phoophiboon V, Owattanapanich N, Owattanapanich W, Schellenberg M. Effects of prone positioning on ARDS outcomes of trauma and surgical patients: a systematic review and meta-analysis. BMC Pulm Med. 2023 Dec 13;23(1):504. doi: 10.1186/s12890-023-02805-w. PMID: 38093216; PMCID: PMC10716936.