Abstract: Veno-venous Extracorporeal membrane oxygenation (VV-ECMO) is commonly used in the treatment of severe ARDS. It improves gas exchange，“rests” the lungs，and reduces ventilator-induced lung injury in ARDS patients with refractory hypoxemia and/or hypercapnia. Prone positioning (PP) is recommended by the guidelines for improving oxygenation and reducing mortality in moderate-to-severe ARDS patients. Due to the lack of clinical research evidence and relevant experience associated with prone positioning during extracorporeal support，patients on VV-ECMO support have historically been managed in supine position. Recently，a number of studies have reported the feasibility of PP during VV-ECMO assistance，which is associated with an improvement of oxygenation，CO2 clearance and respiratory system compliance. This paper reviews the research progress of PP application during VV-ECMO assistance by collecting relevant research evidence.

Key words: extracorporeal membrane oxygenation, acute respiratory distress syndrome, prone ventilation, child

摘要： 静脉-静脉体外膜肺氧合（veno-venous extracorporeal membrane oxygenation，VV-ECMO）可以改善难治性低氧血症和（或）高碳酸血症急性呼吸窘迫综合征（ARDS）患者气体交换，从而使肺“休息”，并降低呼吸机诱导的肺损伤，常用于重度ARDS抢救治疗。俯卧位（prone positioning, PP）可改善中重度ARDS患者氧合、降低病死率，并被指南所推荐。对于俯卧位在VV-ECMO辅助期间的临床研究相对较少，缺少相关经验,VV-ECMO辅助期间患者往往处于仰卧位（supine position，SP）。近年来，越来越多的证据表明VV-ECMO辅助期间俯卧位可改善重度ARDS患者氧合、清除二氧化碳及改善呼吸系统顺应性，且无重大不良事件。该文结合相关文献证据对VV-ECMO辅助期间应用俯卧位进行相关综述。

关键词: 体外膜肺氧合, 急性呼吸窘迫综合征, 俯卧位通气, 儿童