Brachial Plexus Injury After Prone Positioning

The goal of this prospective observational study is to estimate the prevalence of brachial plexus injury after prone positioning in patients with ARDS and to evaluate the safety of swimmer position. The main questions it aims to answer are:Could arm positioning during pronation play a role in the development of any nerve injury at the brachial plexus level?Is swimmer position safe when adopted during prone positioning?Participants will be studied at selective time points using EMG assessment.

Inclusion Criteria:Age ≥ 18 years oldAdmission to ICU for severe ARDSAdministration of sedation and neuromuscular blocking agentsPresence of endotracheal intubation and mechanical ventilationUse of prone positioning to treat hypoxemiaExclusion Criteria:Extracorporeal membrane oxygenationProne positioning performed in other centersProne positioning contraindicationsNeurodegenerative disordersPrevious known brachial plexus injury