ObjectiveThe left lateral decubitus position is generally accepted as the position of choice to protect against aspiration pneumonia in comatose poisoned patients. We studied the relationship between initial body position during coma and subsequent development of suspected aspiration pneumonia (SAP).DesignObservational, descriptive study.SettingToxicology intensive care unit in a university hospital.PatientsAcutely poisoned comatose patients admitted to our intensive care unit.InterventionsNone.Measurements and Main ResultsGlasgow Coma Scale score (GCS) and body position were recorded in poisoned patients on discovery. Chest radiographs were examined for infiltrates suggesting SAP within 24 hrs of hospitalization.The prone positioned patients had a lower incidence of SAP than patients in the lateral decubitus and supine positions, despite similar GCS scores.Patients in the semi-recumbent position had an incidence of SAP similar to prone patients, but with higher GCS values.ConclusionsThe prone position appears to be associated with a lower incidence of SAP than the lateral decubitus position in comatose poisoned patients. (Crit Care Med 1999; 27:745-748)