EFFECTS OF INTERMITTENT PRONE POSITIONING IN THE TREATMENT OF SEVERE POSTTRAUMATIC LUNG INJURY

The influence of intermittent prone positioning on pulmonary gas excha nge and parenchymal densities was investigated in ten patients. Three patients fulfilled the criteria of ''severe ARDS''; seven patients had moderate lung injury as documented by the ''lung injury score'' (LIS) . Nine out of ten were trauma patients and had an average injury sever ity score of 32.3. The oxygenation index (p(a)O2/F(i)O2) improved in a ll patients after prone positioning, showing an increase of 81 +/- 47 (20 - 197) mmHg (MV +/- SD). Total static lung compliance showed an in crease of 7.6 (0-16) ml/mbar. Patients with ARDS benefitted especially from intermittent prone positioning, resulting in a substantial impro vement of the LIS of 0.91 (0.75-1.0) points. In moderate lung injury t he LIS improved 0.5 (0.25-1.0) points. In lung computerized tomography , we observed the disappearance of posterobasal densities. Repeated pr one positioning may therefore be used in ARDS patients as well as in p atients with moderate lung injury.