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 Vol. 5 No. 5, May 2001
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AAP Grand Rounds 5:48-49 (2001)
© 2001 American Academy of Pediatrics

CRITICAL CARE

Prone Position is Best for Acute Respiratory Failure

Source: Kornecki A, Frndova H, Coates A, et al. A randomized trial of prolonged prone positioning in children with acute respiratory failure. Chest. 2001;119:211–218.[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.

Using a 2-crossover study design to compare the effect of prone and supine positioning on oxygenation, 10 children from the Hospital for Sick Children in Toronto, Ontario, with acute respiratory failure were randomized into 1 of 2 groups: supine/prone sequence and prone/supine sequence. Acute respiratory failure was defined as acute bilateral pulmonary infiltrates without evidence of cardiogenic pulmonary edema. Oxygenation impairment was expressed as the oxygenation index [OI = (mean airway pressure x FiO2)(100)/PaO2)]. Study admission required an OI ≥ 12 on FiO2 ≥ 0.5. Exclusion criteria included an OI > 40, hemodynamic instability, congenital heart disease or chronic lung disease. Cardiorespiratory parameters as well as blood gas analysis were collected at baseline, then 30 minutes after changing position and at 2, 4, 6, 8 and 12 hours . . . [Full Text of this Article]

Susan L. Bratton, MD, MPH, FAAP
Pediatric Critical Care Medicine, University of Michigan and Mott’s Children’s Hospital, Ann Arbor, MI