Efficacy of prone position in acute respiratory distress syndrome patients: A pathophysiology-based review

Table 3 Absolute and relative contraindications to prone positioning

Absolute

Unmonitored or significantly increased intracranial pressure

Unstable vertebral fractures

Relative

Difficult airway management

Tracheal surgery or sternotomy during the previous 15 d

New tracheostomy (less than 24 h)

Single anterior chest tube with air leaks

Serious facial trauma or facial surgery during the previous 15 d

Increased intraocular pressure

Hemodynamic instability or recent cardiopulmonary arrest

Cardiac pacemaker inserted in the last 2 d

Ventricular assist device

Intra-aortic balloon pump

Deep venous thrombosis treated for less than 2 d

Massive hemoptysis requiring an immediate surgical or interventional radiology procedure

Continuous dialysis

Severe chest wall lesions ± rib fractures

Recent cardiothoracic surgery/unstable mediastinum or open chest

Multiple trauma with unstabilized fractures

Femur, or pelvic fractures ± external pelvic fixation

Pregnant women

Recent abdominal surgery or stoma formation

Kyphoscoliosis

Advanced osteoarthritis or rheumatoid arthritis

Body weight greater than 135 kg