Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. May 4, 2016; 5(2): 121-136
Published online May 4, 2016. doi: 10.5492/wjccm.v5.i2.121
Efficacy of prone position in acute respiratory distress syndrome patients: A pathophysiology-based review
Vasilios Koulouras, Georgios Papathanakos, Athanasios Papathanasiou, Georgios Nakos
Vasilios Koulouras, Georgios Papathanakos, Athanasios Papathanasiou, Georgios Nakos, Intensive Care Unit, University Hospital of Ioannina, 45500 Ioannina, Greece
Author contributions: All authors equally contributed to this paper with literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Vasilios Koulouras, Associate Professor in Intensive Care Medicine, Intensive Care Unit, University Hospital of Ioannina, Stavros Niarchos Avenue, 45500 Ioannina, Greece. vpkoulouras@yahoo.gr
Telephone: +30-26-51099353 Fax: +30-26-51099343
Received: November 28, 2015
Peer-review started: November 30, 2015
First decision: December 28, 2015
Revised: January 11, 2016
Accepted: March 7, 2016
Article in press: March 9, 2016
Published online: May 4, 2016
Processing time: 150 Days and 2 Hours
Core Tip

Core tip: Lung protective ventilation has become the standard treatment strategy for patients with acute respiratory distress syndrome (ARDS). The physiological basis of prone positioning seems to act beneficially in most pathophysiological disorders of ARDS improving hemodynamics, gas exchange and respiratory mechanics. Moreover prone positioning seems to exert an additional beneficial effect against ventilator-induced lung injury. In patients with severe ARDS, early use of prolonged prone positioning in conjunction with lung-protective strategies decreases mortality significantly.