Abstract

Objective:
Effective pressure management and comfort during prone positioning are core to improved ergonomics and patient tolerance, minimising the need for enhanced respiratory support techniques, such as mechanical ventilation. This study explored the impact of a new (low-tech) pillow solution on interface pressure and comfort during prone positioning compared with standard hospital solutions.

Method:
In this healthy patient cohort, within-subject, comparative study, person–surface interface pressures were measured for three different conscious prone positioning conditions: a standard hospital pillow at the head (HPO); a three-pillow standard hospital proning solution (HPP); and a new two-pillow prone positioning solution with additional standard head pillow (LPP). Contact surface area, peak and mean pressure, peak pressure index (PPI) (head, trunk, pelvis, legs), and subjective comfort were calculated for all conditions over a 21-minute period.

Results:
The study cohort comprised 20 healthy volunteers. The LPP solution lowered PPI at the trunk compared to HPP (p<0.017) and HPO (p<0.001). The LPP solution also significantly reduced head PPI compared to lying with only a head support (p<0.002). Both HPP and LPP significantly improved comfort compared to proning with a head support only (both p<0.002).

Conclusion:
Overall, improved pressure management and comfort was noted for the alternative prone positioning kit, compared with existing solutions, suggesting a low-tech alternative to improving tolerance and adherence of patient prone positioning.