The Effect of Prone Positioning on the Hemodynamics in Children with Acute Respiratory Distress Syndrome

Abstract

Mechanical ventilation in the prone position has been evaluated as a strategy to improve oxygenation and lung recruitment in acute respiratory failure. The mechanisms by which prone positioning may benefit patients with acute respiratory distress syndrome (ARDS) undergoing mechanical ventilation include improving • Ventilation–Perfusion matching. • Increasing end-expiratory lung volume. • Preventing VILI by more uniform distribution of tidal volume through lung recruitment and changes in chest wall mechanics. Prone positioning transferred from a salvage therapy for refractory hypoxemia to a lung-protective strategy intended to improve survival in severe ARDS. Prone positioning has never been proved to allow a survival advantage when used as a late rescue management for refractory hypoxemia. Thus, following up patients’ hemodynamic parameters during prone position is important to detect early hemodynamic instability and termination of prone position procedure. The aim of the study was to determine the hemodynamic effects of prone position in children with acute respiratory distress syndrome (ARDS).