Prone Positioning of Trauma Patients With Acute Respiratory Distress Syndrome and Open Abdominal Incisions

To date, few studies have investigated the effects of prone positioning in trauma patients with ARDS, particularly those with open abdominal wounds. Two case reports are presented in this article, involving 2 trauma patients for whom traditional methods of prone positioning were not feasible. In both cases, periods of prone positioning were successfully accomplished by using new and rather unconventional methods.

Acute respiratory distress syndrome (ARDS) is a serious complication for patients with multiple trauma and may contribute to prolonged hospitalization and morbidity and mortality. ARDS is characterized by acute inflammatory lung injury that results in widespread pulmonary edema because of an increase in capillary permeability. Diagnostic criteria for ARDS are respiratory failure as indicated by evidence of acute bilateral infiltrates on chest radiographs, severe hypoxemia (ratio of Pao₂ to fraction of inspired oxygen <200), and no...