The spectrum of coronavirus disease 2019 (COVID-19) ranges from asymptomatic to acute respiratory distress syndrome (ARDS). Prone position has been widely used in ARDS patients with mechanical ventilation and its benefits have been proven. The prone position in the awake patient is a different procedure than in the patient under invasive mechanical ventilation. This maneuver can be extrapolated to non-intubated patients with COVID-19, avoiding mechanical ventilation in some patients. Previous reports have demonstrated the benefits of this intervention.

The spectrum of coronavirus disease 2019 (COVID-19) ranges from asymptomatic to acute respiratory distress syndrome (ARDS). Prone position has been widely used in ARDS patients with mechanical ventilation and its benefits have been proven. This maneuver can be extrapolated to non-intubated patients with COVID-19, avoiding mechanical ventilation in some patients. Previous reports have demonstrated the benefits of this intervention.

Purpose: The efficacy of partial ventilatory support modes that allow spontaneous breathing in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) is unclear. The objective of this scoping review was to assess the effects of partial ventilatory support on mortality, duration of mechanical ventilation, and both hospital and intensive care unit (ICU) lengths of stay (LOS) for patients with ALI and ARDS; the secondary objective was to describe physiologic effects on hemodynamics, respiratory system and other organ function. Methods: MEDLINE (1966–2009), Cochrane,

<b>Background/Objectives:</b> Respiratory failure in late pregnancy represents a complex and high-risk clinical scenario due to physiological adaptations during pregnancy that reduce maternal respiratory reserve, with tightly coupled maternal and foetal outcomes. This review aims to synthesise current evidence on epidemiology, maternal-foetal physiology, and management strategies for respiratory failure in late gestation. <b>Methods:</b> This narrative review integrates contemporary literature, national surveillance data, physiological principles, and expert consensus to summarise the causes, clinical implications, and management of respiratory failure in pregnancy. <b>Results:</b> Respiratory failure in pregnancy arises from diverse obstetric and non-obstetric conditions, including pneumonia, asthma, pulmonary embolism, cardiogenic pulmonary oedema, and ARDS. Maternal hypoxaemia is strongly associated with foetal compromise. Management requires pregnancy-specific ventilatory targets, avoidance of permissive hypercapnia, cautious use of non-invasive and invasive ventilation, and safe implementation of prone or semi-prone positioning. ECMO use has expanded, with maternal survival improving to approximately 75%, although optimal anticoagulation and timing of delivery remain uncertain. <b>Conclusions:</b> Effective management of respiratory failure in late pregnancy requires early recognition, multidisciplinary coordination, and adaptation of respiratory support to maternal-foetal physiology. Despite improvements in critical care and ECMO outcomes, key evidence gaps persist, underscoring the need for integrated maternal critical care pathways and further research to optimise outcomes for both mother and baby.

<h4>Background</h4>Dexmedetomidine is increasingly used as an anxiolytic and sedative in pediatric patients with acute respiratory distress for managing anxiety and agitation. However, its effectiveness and safety in the pediatric population remain unclear, and clinical practice is often guided by evidence derived from adults.<h4>Aim</h4>A systematic review was conducted to examine the evidence on the use of dexmedetomidine in patients undergoing non-invasive respiratory support (NRS) for acute respiratory conditions in both pediatric and adult individuals.<h4>Methods</h4>A comprehensive literature search was conducted on PubMed, Web of Science and Embase up to September 2025, evaluating dexmedetomidine in patients requiring NRS. The risk of bias was assessed using JBI's critical appraisal tools, and available comparative studies randomized controlled studies (RCT) were analyzed in a meta-analysis. Certainty was graded according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology.<h4>Results</h4>Ten studies evaluating dexmedetomidine in pediatric NRS were identified. While most studies suggested that dexmedetomidine may improve tolerance to NRS and reduce agitation, the pediatric evidence base consists mainly of observational studies without randomized trials, preventing a quantitative synthesis. Consequently, any direct comparisons with adult results cannot be directly extrapolated and should be considered strictly exploratory. Twenty-four studies (9 RCTs) were conducted in adult patients. The evidence from adult studies was more robust, showing that dexmedetomidine has the potential to reduce agitation, aid NRS acceptance, and decrease the need for intubation, as well as the incidence of delirium.<h4>Conclusion</h4>Current evidence supporting the use of dexmedetomidine in pediatric patients undergoing NRS is promising but remains insufficient. Findings from adult populations suggest that dexmedetomidine can effectively reduce agitation and may facilitate NRS acceptance in various conditions requiring respiratory support. However, future robust randomized controlled trials in pediatric patients are needed to determine efficacy, optimal dosing and safety in children with acute respiratory distress. These data will enable the development of age-specific guidelines and recommendations, ensuring a safer and more effective use.

■ a : : 1 Thoracic ARDS Extrathoracic ARDS Thoracic and extrathoracic ARDS Major etiologies Inhalation … cause of ARDS; complement-split products are not specific markers of ARDS. In ARDS, particularly … tracheal intubation and mechanical ventilation are usually required. Mechanical ventilation The aims