a) Discuss the use of prone positioning in critically ill patients with respiratory failure. Include in your answer the rationale, advantages and disadvantages of prone positioning in the critically ill in both awake and intubated patients. (80% marks)
b) Outline the important findings, strengths and weaknesses of the PROSEVA trial. (20% marks)
The average reader doing these papers to prepare for the CICM Second Part Exam will probably want to see a model answer representing something the average trainee could write in under 10 minutes, rather than an elaborate explanation of how and why prone ventilation works. That elaborate explanation is available on the prone ventilation page, and in the physiology-oriented CICM First Part Exam page dealing with the effects of positioning on the mechanics of breathing.
Sodhi, Kanwalpreet, and Gunjan Chanchalani. "Awake proning: current evidence and practical considerations." Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine 24.12 (2020): 1236.
Messerole, Erica, et al. "The pragmatics of prone positioning." American journal of respiratory and critical care medicine 165.10 (2002): 1359-1363.
Koeckerling, David, et al. "Awake prone positioning in COVID-19." Thorax 75.10 (2020): 833-834.
Guerin, Claude, et al. "Effects of systematic prone positioning in hypoxemic acute respiratory failure: a randomized controlled trial." Jama 292.19 (2004): 2379-2387.