Pediatric anesthesia & critical care
Impact of patient positioning on the occurrence of perioperative respiratory adverse events in children -a cluster randomised trial – The POSSUM trial
Authors' conclusion
Overall, standardized perioperative HE30 did not influence the occurrence of PRAE in children undergoing general anaesthesia.
Study context
- Population
- Children undergoing surgery under GA, managed in-hoursPhase One
- Participants
- 1,935 children
- Comparison
- HE30 vs no head elevation (NHE)
- HE30n = 959
- NHEn = 976reference
- Primary endpoint
- Overall incidence of PRAE
Methodological detailsprospective, two phases, weekly alternating allocation, Phase One: allocated positions alternated weekly for 8 weeks, Phase Two: 4-week period of routine practice, positioning at clinician's discretion
- Prospective
- Two phases
- Weekly alternating allocation
- Phase One: allocated positions alternated weekly for 8 weeks
- Phase Two: 4-week period of routine practice, positioning at clinician's discretion
Primary result
As reported in the abstract
P = 0.42
Further findings
PRAE in patients managed with a tracheal tube (TT) (subgroup)
P = 0.017
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| PRAE in patients managed with a tracheal tube (TT) (subgroup)Multivariable | 1.75 (1.01–3.02) | P = 0.04 | |
| PRAE, Phase One vs Phase Two (routine practice, n = 905)Both 14% | 0.93 (0.74–1.17) | P = 0.53 | |
| 0.20.5125Odds ratio (log scale) |
Perioperative respiratory adverse events (PRAE), Phase One vs Phase Two (routine practice, n = 905)
- NHE and 15-degree head-elevated positions preferred by staff in Phase Two
Original publication
Impact of patient positioning on the occurrence of perioperative respiratory adverse events in children -a cluster randomised trial – The POSSUM trial. Anaesth Crit Care Pain Med. Published 7 July 2026. doi:10.
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