Prone position: Contraindications^*

Absolute contraindications

Spinal instability or at risk of spinal instability (eg, rheumatoid arthritis)
Multiple fractures or trauma (eg, unstable fractures of femur, pelvis, face)
Anterior burns, anterior chest tubes, anterior open wounds
Acute shock (eg, hemorrhagic shock)
Raised intracranial pressure >30 mmHg or cerebral perfusion pressure <60 mmHg
Recent tracheal surgery or sternotomy within 2 weeks
Peritoneal dialysis

Relative contraindications

Hemodynamic instability (eg, persistent mean arterial pressure <65 mmHg despite vasopressors)
Cardiac abnormalities, such as freshly placed pacemaker, life-threatening arrhythmias, ventricular assist devices, balloon pumps^¶
Major thoracic and abdominal surgery
Clinical conditions limiting life expectancy^Δ (eg, oxygen or ventilator-dependent respiratory failure)
Difficult airway or intubation
Massive hemoptysis
Peritoneal dialysis
Pregnancy

* As time has progressed and experience improved with pronation, many relative contraindications have been removed from the list or case reports of success have occurred, especially if the need arises (eg, pregnancy).

¶ Devices may be easily dislodged, or immediate access for cardiopulmonary resuscitation may be needed urgently.

Δ Based upon exclusion criteria from the Prone Positioning in Severe ARDS trial (PROSEVA).

Graphic 68536 Version 9.0

خرید پکیج

Prone position: Contraindications*

Prone position: Contraindications^*