Related Experiment Video

Updated: Mar 5, 2026

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
07:16

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient

Published on: November 30, 2022

5.1K

Prone Positioning Improves Ventilation Homogeneity in Children With Acute Respiratory Distress Syndrome

Alison Lupton-Smith1, Andrew Argent, Peter Rimensberger

  • 11Department of Paediatrics, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa. 2Paediatric Intensive Care Unit, Red Cross War Memorial Children's Hospital, Cape Town, South Africa. 3Department of Paediatrics, University Hospital of Geneva, Geneva, Switzerland. 4Department of Anesthesiology and Intensive Care Medicine, University Medical Centre Schleswig-Holstein, Campus Kiel, Germany. 5University Medical Centre Schleswig-Holstein, Campus Kiel, Germany.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|March 23, 2017
PubMed

Insights

Prone positioning in children with acute respiratory distress syndrome (ARDS) showed variable effects on ventilation distribution. However, it improved ventilation homogeneity and potentially recruited dorsal lung regions in responders.

Area of Science:

  • Pediatric Critical Care Medicine
  • Respiratory Physiology
  • Medical Imaging

Background:

  • Acute respiratory distress syndrome (ARDS) in children presents significant challenges in mechanical ventilation.
  • Understanding ventilation distribution is crucial for optimizing ARDS management.
  • Prone positioning is a recognized intervention for ARDS, but its effects on ventilation heterogeneity in pediatric populations require further elucidation.

Purpose of the Study:

  • To investigate the impact of prone positioning on ventilation distribution in mechanically ventilated children diagnosed with ARDS.
  • To assess regional ventilation changes and overall ventilation homogeneity in supine versus prone positions.

Main Methods:

  • A prospective observational study was conducted in a pediatric intensive care unit.
  • Electrical impedance tomography (EIT) was used to measure ventilation distribution in supine and prone positions.
  • Patients included mechanically ventilated children with ARDS; responders were defined by a >10% improvement in oxygenation index after 60 minutes in prone position.

Main Results:

  • Twelve children with ARDS were studied; four were responders, three nonresponders, and five showed no change.
  • Ventilation distribution between ventral and dorsal lung regions did not significantly differ in supine versus prone positions across response groups.
  • Responders demonstrated increased ventilation proportion in dorsal lung regions and improved ventilation homogeneity in both ventral and dorsal lung areas over time in the prone position.

Conclusions:

  • The response to prone positioning in pediatric ARDS is heterogeneous.
  • Prone positioning can enhance ventilation homogeneity and promote recruitment of dorsal lung regions in responsive children.
  • EIT is a valuable tool for assessing regional ventilation changes during prone positioning in pediatric ARDS.
Abstract

More Related Videos

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation07:15

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation

Published on: December 5, 2025

478
Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS06:22

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS

Published on: April 7, 2021

3.9K

Related Concept Videos

Anatomical Positions01:11

Anatomical Positions

In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
20.9K
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
564
Mechanical Ventilation III: Noninvasive Ventilation01:23

Mechanical Ventilation III: Noninvasive Ventilation

Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
682
Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

Cardiopulmonary Resuscitation II: ACLS Airway Management

Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
837
Acute Respiratory Failure-IV01:23

Acute Respiratory Failure-IV

Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
638
Assessment of Ventilation I: Respiratory Rate01:20

Assessment of Ventilation I: Respiratory Rate

Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
2.5K