Prolonged Vs Shorter Awake Prone Positioning for COVID-19 Patients with Acute Respiratory Failure: a Multicenter, Randomised Controlled Trial.

Ling Liu,Qin Sun,Hongsheng Zhao,Weili Liu,Xuehua Pu,Jibin Han,Jiangquan Yu,Jun Jin,Yali Chao,Sicong Wang, Yu Liu, Bin Wu, Ying Zhu,Yang Li,Wei Chang,Tao Chen,Jianfeng Xie,Yi Yang,Haibo Qiu,Arthur Slutsky

INTENSIVE CARE MEDICINE（2024）

Cited 0|Views17

Abstract

Awake prone positioning has been reported to reduce endotracheal intubation in patients with coronavirus disease 2019 (COVID-19)-related acute hypoxemic respiratory failure (AHRF). However, it is still unclear whether using the awake prone positioning for longer periods can further improve outcomes. In this randomized, open-label clinical trial conducted at 12 hospitals in China, non-intubated patients with COVID-19-related AHRF were randomly assigned to prolonged awake prone positioning (target > 12 h daily for 7 days) or standard care with a shorter period of awake prone positioning. The primary outcome was endotracheal intubation within 28 days after randomization. The key secondary outcomes included mortality and adverse events. In total, 409 patients were enrolled and randomly assigned to prolonged awake prone positioning (n = 205) or standard care (n = 204). In the first 7 days after randomization, the median duration of prone positioning was 12 h/d (interquartile range [IQR] 12–14 h/d) in the prolonged awake prone positioning group vs. 5 h/d (IQR 2–8 h/d) in the standard care group. In the intention-to-treat analysis, intubation occurred in 35 (17

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Key words

Prolonged awake prone positioning,COVID-19-related acute respiratory failure,Intubation,Mortality

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