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Case Reports
. 2025 May 28;19(1):255.
doi: 10.1186/s13256-025-05311-1.

Awake prone positioning in a patient with respiratory impairment due to subarachnoid hemorrhage: a case report

Giorgia Pacchiarini  1 , Federico Geraldini  2 , Alessandro De Cassai  3   4 , Giulia Aviani Fulvio  1 , Annalisa Boscolo  1   5   6 , Francesco Zarantonello  5 , Paolo Navalesi  1   5 , Marina Munari  2
Affiliations
Case Reports

Awake prone positioning in a patient with respiratory impairment due to subarachnoid hemorrhage: a case report

Giorgia Pacchiarini et al. J Med Case Rep. .

Abstract

Background: Prone positioning has been shown to be an effective rescue strategy in severe acute respiratory distress syndrome and was widely used during the coronavirus disease 2019 pandemic, both in mechanically ventilated and in awake patients. Subarachnoid hemorrhage is often associated with respiratory failure. Prone positioning has been used in brain-injured patients, but concerns relating to neurological complications from intracranial hypertension still remain.

Case presentation: We report the case of a 59-year-old Italian patient with subarachnoid hemorrhage who safely underwent awake prone positioning after deterioration of respiratory function.

Conclusions: In this report, we show that awake pronation is possible in patients with subarachnoid hemorrhage. However, careful monitoring of Intracranial pressure and clinical examination may be the keys to successful application of this procedure.

Keywords: Pronation; Pulmonary gas exchange; Respiratory distress syndrome; Respiratory insufficiency; Subarachnoid hemorrhage.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Computed tomography scan showing subarachnoid hemorrhage and the clip on the aneurysm
See this image and copyright information in PMC

References

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