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Vol. 45. Issue 6.
Pages 291-296 (June 2009)
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Vol. 45. Issue 6.
Pages 291-296 (June 2009)
Review article
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Prone Position for the Treatment of Acute Respiratory Distress Syndrome: A Review of Current Literature
Evidencias de la posición en decúbito prono para el tratamiento del síndrome de distrés respiratorio agudo: una puesta al día
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Óscar Martínez, Nicolás Nin, Andrés Esteban
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aesteban@ucigetafe.com

Corresponding author.
Servicio de Cuidados Intensivos, CIBER de Enfermedades Respiratorias CB06/06/0044, Instituto de Salud Carlos III, Hospital Universitario de Getafe, Getafe, Madrid, Spain
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Abstract

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) have high incidence and mortality rates. Most of the recently introduced treatments have failed to improve the prognosis of patients with ALI or ARDS or to reduce mortality. Several studies have shown improved oxygenation in the prone position during mechanical ventilation in patients with ARDS. However, current evidence strongly suggests that placing ARDS patients in prone position does not improve survival or reduce the duration of mechanical ventilation. Therefore, though in clinical practice this position may improve refractory hypoxemia in patients with ARDS, there is no evidence to support its systematic use.

Keywords:
Acute respiratory distress syndrome
Acute lung injury
Mechanical ventilation
Prone position
Resumen

La incidencia y la mortalidad de la lesión pulmonar aguda y del síndrome de distrés respiratorio agudo (SDRA) son altas. La mayoría de los nuevos tratamientos no han mejorado el pronóstico de los pacientes con lesión pulmonar aguda/SDRA, de modo que se ha observado una mortalidad similar en los últimos años. Varios estudios han evidenciado un aumento de la oxigenación con el decúbito prono durante la ventilación mecánica en pacientes con SDRA. Actualmente existe una fuerte evidencia de que el decúbito prono en pacientes con SDRA no mejora la supervivencia ni disminuye los días de ventilación mecánica. Por lo tanto, a pesar de que en la práctica clínica puede utilizarse dicha posición para mejorar la hipoxemia refractaria en pacientes con SDRA, no hay evidencia para recomendarla de forma sistemática en estos pacientes.

Palabras clave:
Síndrome de distrés respiratorio agudo
Lesión pulmonar aguda
Ventilación mecánica
Decúbito prono
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