Associations of Awake Prone Positioning-Induced Changes in Physiology with Intubation : An International Prospective Observational Study in Patients with Acute Hypoxemic Respiratory Failure Related to COVID-19
Morales-Quinteros, Luis (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Scala, Raffaele (S Donato Hospital (Itàlia))
Silva, João Manoel (Hospital das Clinicas)
Leidi, Antonio (Geneva University Hospitals (Ginebra, Suïssa))
Leszek, Alexandre (Geneva University Hospitals (Ginebra, Suïssa))
Vazquez-Guillamet, Rodrigo (Washington University)
Pascual-Guardia, Sergi (Hospital del Mar (Barcelona, Catalunya))
Serpa-Neto, Ary (Austin Health (Austràlia))
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Schultz, Marcus J. (Mahidol University)
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	Awake prone positioning has the potential to improve oxygenation and decrease respiratory rate, potentially reducing the need for intubation in patients with acute hypoxemic respiratory failure. We investigated awake prone positioning-induced changes in oxygenation and respiratory rate, and the prognostic capacity for intubation in patients with COVID-19 pneumonia. International multicenter prospective observation study in critically ill adult patients with COVID-19 receiving supplemental oxygen. We collected data on oxygenation and respiratory rate at baseline, and at 1 h after being placed in prone positioning. The combined primary outcome was oxygenation and respiratory rate at 1 h. The secondary endpoint was treatment failure, defined as need for intubation within 24 h of start of awake prone positioning. Between March 27th and November 2020, 101 patients were enrolled of which 99 were fully analyzable. Awake prone positioning lasted mean of 3 [2-4] h. In 77 patients (77. 7%), awake prone positioning improved oxygenation, and in 37 patients (54. 4%) it decreased respiratory rate. Twenty-nine patients (29. 3%) were intubated within 24 h. An increase in SpO/FiO of < 10 (OR 5. 1, 95% CI 1. 4-18. 5, P = 0. 01), a failure to increase PaO/FiO to.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Acute hypoxemic respiratory failure ; Awake prone position ; Coronavirus disease ; COVID-19 ; Intubation ; Prognostication ; Self-proning
Published in:	Pulmonary Therapy, Vol. 9 (november 2023) , p. 499-510, ISSN 2364-1746

DOI: 10.1007/s41030-023-00242-y
PMID: 37917322

12 p, 759.8 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
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