Adult respiratory distress syndrome (ARDS) is a disease in the intensive care unit where mortality is high and treatment is not easy. Among all the causes of ARDS death, hypoxemia accounted for 9-16%. Although the concept of low tidal volume ventilation reduces mortality, however, the progress of other treatments is very limited. In order to improve the oxygenation of these patients, prone positioning ventilation began to be used clinically in the 1970s. However, there is no evidence of absolute benefit to treatment or prognosis until the PROSEVA study, which established that prone ventilation can reduce mortality in severe ARDS patients. Today, for patients with severe hypoxemic ARDS, if there are no contraindications, we should include prone ventilation as an option for treatment and do so as soon as possible.

 

直至今日，成人呼吸窘迫症候群(ARDS)仍然是加護病房中死亡率高且治療不易的一個疾病。在所有造成ARDS死亡的原因中，因為低血氧導致的死亡就佔了9-16%。雖然低潮氣容積通氣(low tidal volume ventilation)的觀念降低了死亡率。但是在其他治療的進展上卻非常有限。為了改善這群病人的氧合能力，俯臥通氣(prone positioning ventilation)於1970年代開始應用於臨床，但是並沒有證據顯示對治療或預後有絕對益處。直到 PROSEVA study確立俯臥通氣可以降低重度ARDS病患的死亡率。今日，對於嚴重低血氧的ARDS患者，如果沒有禁忌症，我們都應把俯臥通氣列入治療的選項，並盡早進行。