Prone Positioning on ECMO

The recommendation of prone positioning on ECMO may put fear into the heart of the caregiver.  Thoughts of  inadvertent decannulation, extubation, excessive bleeding, kinked ECMO tubing…

A recent article in RESPIRATORY CARE provided a review of 7 prospective studies or case reports that revealed very few complications related to prone positioning on ECMO.  There were no reports of decannulation, inadvertent extubation, or chest tube dislodgment.  They also reported minimal bleeding from cannula site and no evidence of chest tube site bleeding were reported.

Hemodynamic instability was reported by two of the studies. But the episodes were reported as being short and reversible.

So next time someone suggests prone positioning on ECMO, take the time to carefully plan, gather adequate staff support, and approach the process with confidence that it can be done safely!

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