In adults with moderate-to-severe acute respiratory distress syndrome, prolonged prone positioning combined with lung-protective ventilation is established practice. It improves ventilation-perfusion matching and is recommended in major critical care guidance.
A negative result in children does not transfer to adults, whose disease, airway size and complication profile differ. In adults, prone sessions are typically long, and teams protect the airway, lines and pressure points during and after each turn.
- Continue to consider prolonged prone sessions for adults with moderate-to-severe ARDS on protective ventilation.
- Secure the airway and lines before every turn, and check tube position afterwards.
- Pad the face, chest and knees and inspect pressure areas after each session.
- Do not extrapolate paediatric trial results to adult practice.
Why it matters
A widely reported negative trial can be misapplied to the population in which the intervention works.
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