The aim of this review is to discuss physiological and clinical effects of prone positioning and its most relevant effects in ventilated infants with acute respiratory distress syndrome (ARDS).
The first reference to this theme was reported in 1974. Since that time numerous studies continue to be published.
After a literature review we may conclude that prone positioning improves lung compliance and gas exchange during mechanical ventilation, but the real clinical benefits are not yet fully understood.
The most important physiological effects of prone positioning are: improvement of oxygenation, respiratory mechanics, homogenisation of the pleural pressure gradient, alveolar inflation and ventilation distribution, increasing lung volume and reducing the amount of atelectatic regions, facilitating the drainage of secretions and reducing ventilation-associated lung injury.
This procedure is simple and safe, without cost, with good results in critically ill infants with ARDS but needs training and motivation by the multidisciplinary team.