Prone Positioning in Children With ARDS
Positive Reflections on a Negative Clinical Trial
- Brian P. Kavanagh, MB, FRCPC
- Author Affiliations: Departments of Critical Care Medicine, Anesthesia, and Physiology, Hospital for Sick Children, University of Toronto, Ontario.
- Corresponding Author: Brian P. Kavanagh, MB, FRCPC, Department of Critical Care Medicine, Hospital for Sick Children, 555 U Ave, Toronto, Ontario M5G 1X8, Canada (brian.kavanagh{at}sickkids.ca).
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Acute respiratory distress syndrome (ARDS) is common, highly lethal, and not curable. Although important adult ARDS studies1-2 continue to undergo reappraisal,3-4 promising data have recently been reported for treatment of this entity in children. A recent randomized controlled trial,5 which described a beneficial effect of surfactant, was the first report of an effective treatment for ARDS.
In this issue of JAMA, Curley and colleagues6 from the same research group, the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI), report on the effect of prone positioning in children with ARDS; oxygenation was improved, yet outcomes were unchanged. Clinicians will reflect on these results and ask how to incorporate the findings from this valuable study into providing the best possible care for their patients.
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