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