The Need for randomised controlled trials

Reducing uncertainties and ensuring best practice.

A lot was made of placing people on their fronts to increase the effects of ventilation. This is because In patients with acute respiratory distress syndrome (ARDS), ventilation in the prone position for at least 16 hours per day reduces mortality at 90 days.

But what about in most severe patients? A recent randomised clinical trial showed prone positioning did not reduce time to successful ECMO weaning in the most severe ARDS patients requiring venovenous extracorporeal membrane oxygenation.

Why does this matter? Proning a patient is demanding, as safely turning a patient requires six staff members. In a Southampton intensive care unit, firefighters were called into help out with turning patients.