Prone position complications

Q: Name at least five major potential complications while patient gets treated in prone position.

Answer: In last few years, particularly during COVID pandemic, prone position has become a major modality to treat severe ARDS. Said that it comes with its own set of major and sometimes fatal complications. Some are described below.

• Nerve compressions (particularly brachial plexus injury)
• Crush injury
• Venous stasis (close monitoring needed for facial edema)
• Dislodging endotracheal and other tubes
• Diaphragm limitation
• Pressure sores 
• Dislodgment of central lines or drainage tubes
• Retinal damage
• Gastrointestinal intolerance
• Increased abdominal compartment pressure 
• arrhythmias

#pulmonary

#ARDS

References: 

1.Ryan DW, Pelosi P. The prone position in acute respiratory distress syndrome. BMJ 1996; 312:860.

2. Guérin C, Reignier J, Richard JC, et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 2013; 368:2159.