Severe acute respiratory distress syndrome in a child with malaria: favorable response to prone positioning.
We present the case of a 4-year-old boy with malaria who developed acute respiratory distress syndrome with severe hypoxemia refractory to mechanical ventilation and inhaled nitric oxide. Placing the patient in prone position immediately and persistently improved oxygenation: the ratio of P(aO(2)) to fraction of inspired oxygen rose from 47 to 180 mm Hg and the oxygenation index decreased from 40 to 11. The patient survived, with no respiratory sequelae.
Pediatric Intensive Care Unit, Hospital GU Gregorio Marañón, Dr Castelo 49, 28009 Madrid, Spain.
Jose C
JC
Flores
Ana
A
Imaz
Jesús
J
López-Herce
Carlota
C
Seriñá
D002675:Child, Preschool; D006801:Humans; D008288:Malaria / Q000150:complications*; D008297:Male; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use*; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy; D011175:Positive-Pressure Respiration; D016684:Prone Position / Q000502:physiology*; D012128:Respiratory Distress Syndrome / Q000503:physiopathology / Q000628:therapy*
D009569:Nitric Oxide; D010100:Oxygen