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?

@HonLiangTan

tanhonliang@gmail.com

need references and resources?

tan.hon.liang@singhealth.com.sg