Relation of body position at the time of discovery with suspected aspiration pneumonia in poisoned comatose patients

Objective: The left lateral decubitus position is generally accepted as the position of choice to protect against aspiration pneumonia in comatose poi soned patients. We studied the relationship between initial body position d uring coma and subsequent development of suspected aspiration pneumonia (SA P), Design: Observational, descriptive study. Setting: Toxicology intensive care unit in a university hospital, Patients: Acutely poisoned comatose patients admitted to our intensive care unit. Interventions: None. Measurements and Main Results: Glasgow Coma Scale score (GCS) and body posi tion were recorded in poisoned patients on discovery. Chest radiographs wer e examined for infiltrates suggesting SAP within 24 hrs of hospitalization. The prone positioned patients had a lower incidence of SAP than patients in the lateral decubitus and supine positions, despite similar GCS scores. Pa tients in the semi-recumbent position had an incidence of SAP similar to pr one patients, but with higher GCS values, Conclusions: The prone position appears to be associated with a lower incid ence of SAP than the lateral decubitus position in comatose poisoned patien ts.