How It Works:
The Mechanism of Prone Therapy
Studies have shown that placing patients in the prone position may help:
- Facilitate drainage of pulmonary secretions2
- Decrease pleural pressure in the dependent portions of the lung3
- Eliminate compression of the lungs by the heart4
- Restore ventilation to dorsal lung regions without compromising ventral regions4
- Improve ventilation and perfusion matching5
The Benefits:
Prone Therapy Patient Outcomes
Clinical studies have documented the effectiveness of Prone Therapy:
- Improved 10-day survival rate among high-risk patients1
- Sustained improvement in arterial oxygenation in ARDS patients6
Why It’s Underutilized:
Challenges Associated With Prone Therapy
There are several reasons why Prone Therapy is not used, despite its clinical advantages:
- Manual positioning is labor-intensive7 8 9
- Risk management concerns for both patient and caregiver10
- Additional caregiver time and costs9
- Potential for tube entanglement or separation7 8 9 10
KCI is leading the way in pulmonary critical care by incorporating two clinically proven therapies in one easy-to-use automated system. The RotoProne® Therapy System delivers the benefits of both Prone Therapy and Kinetic Therapy™ to patients suffering from pulmonary complications associated with immobility.
KCI’s TriaDyne® II and TriaDyne Proventa® Therapy Systems offer both Prone Therapy with the Proning Accessory Kit and Kinetic Therapy™ for customized patient treatment and prevention of pulmonary complications. These therapies also help in the prevention and treatment of skin breakdown associated with immobility and can lead to shorter ventilation time and stay in the ICU for patients11 12 .
By improving outcomes and reducing complications for critically ill patients, KCI’s Critical Care Therapies™ are changing the standard of healing in critical care.
1 Gattinoni, L, Tognoni G, Pesenti A, Taccone P, Mascheroni D, Labarta V, Malacrida R, Di Giulio P, Fumagalli R, Pelosi P, Brazzi L, Latini R, Effect of Prone Position on the Survival of Patients with Acute Respiratory Failure, The New England Journal of Medicine, 2001; 345: 568-573.
2 Pelosi P., Brazzi L., Gattinoni L. Prone Position in Acute Respiratory Distress Syndrome. European Respiratory Journal. 2002 Oct; 20 (4): 1017-1028.
3 Mutoh T, Guest RJ, Lamm W, Albert RK. Prone Position Alters the Effect of Volume Overload on Regional Pleural Pressures and Improves Hypoxemia in Pigs in Vivo. Am. Rev. Respir. Dis. 1992; 146: 330-306.
4 Albert R, Hubmayr R. The Prone Position Eliminates Compression of the Lungs by the Heart. American Journal Respiratory Critical Care Medicine, 2000; 161: 1660-1665.
5 Pappert D, Rossaint R, Slama K et al. Influence of Positioning on Ventilation – Perfusion Relationships in Severe Adult Respiratory Distress Syndrome. Chest, 1994; 106: 1511-1516.
6 Lee D.L. Prone-Position Ventilation Induces Sustained Improvement in Oxygenation in Patients with Acute Respiratory Distress Syndrome Who Have a Large Shunt. Critical Care Medicine. 2002 July; 30(7):1446-1452.
7 Ball C. Use of the Prone Position in the Management of Acute Respiratory Distress Syndrome. Intensive and Critical Care Nursing 2001; 15: 192-203.
8 Rowe, C. Development of Clinical Guidelines for Prone Positioning in Critically Ill Adults. Nursing in Critical Care 2004; 9:50-57.
9 McCormick J. and Blackwood B. Nursing the ARDS Patient in the Prone Position; the Experience of Qualified ICU Nurses. Intensive and Critical Care Nursing 2001; 17: 331-340.
10 Gosheron M, Leaver G, Forester A, et al. Prone Lyinig – a Nursing Perspective. Care of Critically Ill 1998; 14: 89-92.
11 Choi S.C, Nelson LD. Kinetic Therapy™ in Critically Ill Patients: Combined Results Based on Meta-Analysis. Journal of Critical Care, 1992; 7: 57-62.
12 Watanabe, I, et al, Beneficial effect of prone position for patients with hypoxemia after transthoracic esophagectomy, Critical Care Medicine 2002, Aug;30(8):1799-802.
