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Prone Position Haemodynamics — FRCA Final MCQ

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EasyIntensive Care MedicineProne Position HaemodynamicsFRCA Final

A 55-year-old man in the ICU with ARDS has been started on prone positioning. During prone positioning, what is the expected effect on cardiac output?

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Correct answer: D — Usually unchanged or mildly increases in hypovolaemic patients

Prone positioning in ARDS generally has minimal effect on cardiac output in euvolaemic patients, and may modestly improve cardiac output in patients who were hypovolaemic in the supine position (by reducing RV afterload through improved oxygenation and reducing pulmonary vascular resistance). The PROSEVA trial showed prone positioning was safe haemodynamically. Key considerations: ensure adequate intravascular volume before turning, secure all lines and tube, protect pressure areas, and monitor closely during turns.

Reference: Guérin C et al – 2013 – PROSEVA trial; ICS – 2024 – ARDS guidelines