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

Abstract

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 evidence of left atrial hypertension (as indicated by clinical examination or pulmonary artery occlusion pressure <18 mm Hg). The mortality rate for patients with ARDS is as high as 40% to 60%. The actual survivability depends on multiple factors, including predisposing conditions, severity of illness, age, comorbid conditions, and, in patients with trauma, severity of the underlying lung injury. Sepsis is the most frequently identified risk factor for ARDS; other factors are aspiration of gastric material, severe pneumonia, severe trauma, use of cardiopulmonary bypass, multiple transfusions, fat embolism, and pancreatitis. For patients with multiple trauma, factors thought to contribute to the development of ARDS include pulmonary Tracy A. Murray is a nurse practitioner in Miamisburg, Ohio. At the time this article was written, she was a trauma nurse practitioner at Miami Valley Hospital in Dayton, Ohio.