Prone Position is Best for Acute Respiratory Failure

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 …