Proning and high-frequency oscillation may not reduce duration of ventilation for children with lung injury
A treatment that is part of standard care for adults with acute respiratory distress syndrome does not provide the same benefit in children. Children with severe acute lung injury placed in the prone position do not spend less time dependent on a ventilator. High-frequency oscillatory ventilation does not shorten the duration of mechanical ventilation either. This is shown by a worldwide study…
A recent worldwide study led by Dr. Martin Kneyber of the UMCG Pediatric Intensivist found that two common treatments for children with severe lung injury do not shorten the time spent on ventilators. Prone positioning and high-frequency oscillation ventilation, both standard care for adults with acute respiratory distress syndrome (ARDS), showed no benefit in reducing the duration of mechanical ventilation in children with acute respiratory distress syndrome (PARDS).
The study, published in The Lancet, involved over 60 pediatric intensive care units worldwide and examined four combinations of position and ventilation strategy in children aged 0-20 with moderate-to-severe PARDS. The researchers concluded that neither intervention improved ventilator-free days by day 28, and that both prone positioning and high-frequency oscillation ventilation increased the risk of adverse events such as artificial airway obstruction, pressure-related skin injuries, and hemodynamic instability.
The researchers recommend against the routine use of these treatments as first-line therapy for children with moderate-to-severe PARDS, but acknowledge that they may be beneficial as rescue treatment in select patients.
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