Infants With Severe Acute Respiratory Distress Syndrome: The Prone Trial

The main objective is to determine the short-term effect of prone positioning in infants with infection-associated severe acute respiratory distress syndrome. The investigators compare oxygenation parameters and measurements from electrical impedance tomography (EIT) and lung ultrasonography (LUS) in mechanically ventilated infants in prone position versus supine position after surfactant administration.

Inclusion Criteria: * Patients hospitalized at Pediatric Intensive Care Unit (PICU) or Neonatal Intensive Care Unit (NICU) of the Medical University Vienna. * Patients aged \>36 weeks (corrected gestational age) and \94% in the 4 weeks preceding hospitalization in the PICU/NICU * Cyanotic congenital heart disease Cardiogenic pulmonary edema * Severe pulmonary hypertension * Untreated pneumothorax * Severe neurological abnormalities * Other severe congenital anomalies such as congenital diaphragmatic hernia * Ongoing cardiopulmonary resuscitation or limitation of life support * Contradictions for prone positioning (adapted from Guerin, C., et al., Prone positioning in severe acute respiratory distress syndrome. N Engl J Med, 2013. 368(23): p. 2159-68): * Intracranial pressure \>30 millimeters of mercury (mmHg) in supine position or cerebral perfusion pressure \