PRONE POSITIONING: From basic concepts to practice

This article was first written during the outbreak of the SARS-CoV-2 pandemic, even though at the time the contagion is decreasing, I still think it’s very important to offer a small summary of the theory and techniques used during the process of prone positioning in patients affected with ARDS (Acute Respiratory Distress Syndrome). The prone position involves positioning the patient ventral side down and dorsal side up.

The main question is: why do we prone position patients that are affected by ARDS?

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Noninvasive Ventilation: how to start?

Instructions for the reader:

The text contains elements of the little experience I have. It can, therefore, be perfectly questionable, especially the units and data that emerged from literature.

All ventilation settings are under medical supervision and approval (for lovers of nursing diagnosis, this is a collaborative problem). Since certain aspects are strongly linked to local resources and “attitudes”, the interface types and ventilator models will not be discussed.

In recent decades the efficiency of NIV (Noninvasive ventilation) has been used for several clinical conditions, such as cardiogenic pulmonary edema, exacerbation of the COPD, and acute respiratory failure in immunocompromised patients.

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Reverse Triggering

English version edited by Giulia Azzini, Rn, Intensive Care Unit, Department of Anaesthesiology, Emergency and Intensive Care Medicine (DAEICM), Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland.

In order to understand this asynchrony, it is important to know the meaning of ” Entraiment”. In physics, this term defines the phase and the timeline of a periodic external output. In a neuroscientific field, “entrainment” is when the cerebral waves show a superimposable oscillation on a periodic external stimulus. For example, exposure to music can cause a “respiratory entrainment” in the respiratory area of expertise attributed to a permanent and repetitive reaction between neural respiratory cycles distributed by the ventilator.

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