Anestéziológia a intenzívna medicína 1/2021

Positioning patients into the prone position in adult ICU

In the last two decades, randomized controlled trials have shown that in patients with moderate to severe ARDS oxygenation is improved if patients are ventilated in the prone position (PP) for 12 to 16 hours a day. Early application of PP can significantly reduce mortality compared to conventional ventilation. In this review physiological and pathophysiological effects of PP, safety standards, indications and contraindications, necessary equipment, positioning process, nursing procedures aimed at prevention of complications, special situations – procedure in flexible bronchoscopy, resuscitation – further recommendations for nurses (prone positioning checklist) and safety checklist for ventilation in PP are presented. This work should also help healthcare professionals in the treatment of patients with COVID-19.

Keywords: prone position, mechanical ventilation, ARDS, safety, Covid-19