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These two studies, published in 2013, should change the way we manage mechanically ventilated patients in intensive care units.
Patients with acute respiratory distress syndrome (ARDS) often develop consolidation of the dependent lung regions. For many years, physicians have transitioned severely hypoxemic patients from supine to prone positions to improve aeration of these areas and to promote gas exchange. To determine whether this practice prevents ARDS-associated mortality, French researchers randomized 466 mechanically ventilated patients with moderate-to-severe ARDS to daily prone positioning or to supine positioning only. Intervention patients underwent an average of four sessions of proning (mean duration per daily session, 17.3 hour…