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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 led, among others, by UMCG pediatric intensivist Dr. Martin Kneyber. The results were published in The Lancet.

In children with acute respiratory distress syndrome (PARDS), the lungs suddenly become severely inflamed. As a result, oxygen transfer to the bloodstream is impaired. The condition is associated with high morbidity and mortality: children are admitted to the pediatric intensive care unit, where invasive ventilation supports their breathing while physicians treat the underlying cause.

But how can physicians best ventilate these children? For more than 30 years, pediatric critical care clinicians have debated the risk-benefit ratio of prone versus supine positioning and high-frequency oscillatory ventilation (HFOV) versus conventional mechanical ventilation. Prone positioning has shown favorable survival outcomes in adults with ARDS, but are the methods used in adults equally beneficial for children? Until now, there were insufficient data to support either prone positioning or HFOV in PARDS.

To answer these questions, Kneyber, who is affiliated with the Beatrix Children's Hospital of the UMCG, led the international PROSpect study, together with two American colleagues.

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