Payam RAHIMI
Çukurova Anestezi ve Cerrahi Bilimler Dergisi - 2026;9(1):92-96
Aim: Prone positioning (PP) is a well-established strategy to improve oxygenation in acute respiratory distress syndrome (ARDS) patients; however, its role during Venovenous Extracorporeal Membrane Oxygenation (VV-ECMO) remains uncertain. The aim of this study was to evaluate the impact of PP on Intensive Care Unit (ICU) survival and respiratory parameters in patients with ARDS supported by VV-ECMO. Methods: This retrospective observational study included 100 adult patients who underwent VV-ECMO for respiratory failure between 2015 and 2024. Patients were divided into two groups: Those who received prone positioning during ECMO (>=16 hours) and those who remained supine. Clinical characteristics, ventilatory parameters, and outcomes were compared. Results: Forty-five patients (45%) underwent PP during ECMO. Although ICU survival was higher in the prone group (53.7% vs. 46.3%), the difference was not statistically significant (p=0.246). However, PP was associated with significant improvements in driving pressure, mechanical power, compliance, and gas exchange indices in the period following PP. Conclusions: While PP during VV-ECMO did not significantly improve survival, it contributed to favorable physiological changes, supporting its use as an adjunctive therapy in ARDS management under ECMO.
