Premium
Improved arterial oxygenation in children with the adult respiratory distress syndrome: the prone position
Author(s) -
Murdoch IA,
Storman MO
Publication year - 1994
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1994.tb12981.x
Subject(s) - medicine , supine position , prone position , oxygenation , ards , anesthesia , respiratory distress , cardiac output , ventilation (architecture) , arterial blood , blood pressure , mean airway pressure , oxygen saturation , hemodynamics , heart rate , cardiology , oxygen , lung , chemistry , organic chemistry , engineering , mechanical engineering
Seven ventilated children with the adult respiratory distress syndrome (ARDS) were studied. While supine and haemodynamically stable, baseline arterial blood‐gas analyses and haemodynamic measurements, including cardiac output, were performed. Each child was then turned prone and 30 min later a repeat set of measurements were made. Following this, the children were returned to the supine position and 30 min later a final set of measurements were performed. Ventilation and inotropic support remained unchanged during these positional changes. No significant effect on heart rate, mean systemic arterial blood pressure and cardiac output occurred following these positional changes ( p < 0.05; Friedman's ANOVA). Arterial oxygen saturation significantly improved, however, when nursed in the prone position ( p < 0.02). Similarly, oxygen delivery significantly increased ( p < 0.02). The prone position improves arterial oxygenation and oxygen delivery in children with ARDS. By adopting the prone position, in ventilated children with ARDS, we surmise that realistic gas exchange targets may be reachable with lower levels of inspired oxygen and/or peak airway pressures.