Prone positioning for acute respiratory failure improved short term oxygenation but not survival
QUESTION: Does prone positioning for ≥ 6 hours each day for 10 days improve survival of patients with acute lung injury or the acute respiratory distress syndrome (ARDS)?
Design
Randomised (allocation concealed), unblinded, controlled trial with 6 months of follow up.
Setting
28 intensive care units (ICUs) in Italy and 2 in Switzerland.
Patients
304 patients (mean age 58 y, 68% men) who were receiving mechanical ventilation and met the following modified criteria for acute lung injury or ARDS: ratio of partial pressure of arterial oxygen (PaO2) to fraction of inspired oxygen (FiO2) ≤ 200 with a positive end expiratory pressure (PEEP) ≥ 5 cm of water, or a PaO2:FiO2 ratio ≤ 300 with a PEEP ≥ 10 cm water; radiographic evidence of bilateral pulmonary infiltrates; and, if measured, pulmonary-capillary wedge pressure ≤ 18 mm Hg or absence of clinical evidence of left atrial hypertension. Exclusion criteria were age <16 years, cardiogenic …
