Improving Prone Positioning Process for Acute Respiratory ...
Prone positioning for ARDS
27
welcome combined MSICU grand round 6 jan 2016
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Transcript of Prone positioning for ARDS
welcome
combined MSICU grand round
6 jan 2016
prone positioningtan hon liang
insert tragedy here….
early antibiotics
ARDSnet
aprviv steroids
prone positioning?
why do it?prone positioning
sicker
P/F 150
longer
16 hr
stricter
6 ml/kg
1974 2013
(PROSEVA)
~ 8 clinical trials
risk o
f death
untreated risk of death
reduction o
f risk o
f death
untreated risk of death reduction o
f risk o
f death
untreated risk of death
A B C
reduction o
f risk o
f death
untreated risk of death
adverse effectsrisk o
f death
untreated risk of death
treatmentrisk o
f death
untreated risk of death
no treatment
DIGRESSION
A
B
C
Recommended Read
steroids HFOV glutamine
TPN physiotherapy
NaCl vs balanced albumin
how to do it?
practical aspects
secretions
pressure sores
dislodged lines & tubes
hemodynamics
facial edema/airway
why do it this way?Prone Positioning
cardiac respiratory renal
intra-abdominal hypertension
individualized & patient specific
feedback
trial and error
questions?
