Early versus late awake prone positioning in non-intubated patients with COVID-19

Awake prone positioning (APP) is widely used in the management of patients with coronavirus disease (COVID-19). The primary objective of this study was to compare the outcome of COVID-19 patients who received early versus late APP. Post hoc analysis of data collected for a randomized controlled tria...

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Veröffentlicht in:	Critical care (London, England) England), 2021-09, Vol.25 (1), p.340-340, Article 340
Hauptverfasser:	Kaur, Ramandeep, Vines, David L, Mirza, Sara, Elshafei, Ahmad, Jackson, Julie A, Harnois, Lauren J, Weiss, Tyler, Scott, J Brady, Trump, Matthew W, Mogri, Idrees, Cerda, Flor, Alolaiwat, Amnah A, Miller, Amanda R, Klein, Andrew M, Oetting, Trevor W, Morris, Lindsey, Heckart, Scott, Capouch, Lindsay, He, Hangyong, Li, Jie
Format:	Artikel
Sprache:	eng
Schlagworte:	Acute hypoxemic respiratory failure Awake prone positioning Clinical outcomes Collaboration Coronavirus Coronaviruses COVID-19 COVID-19 - complications COVID-19 - mortality COVID-19 - therapy Critical care Enrollments Ethnicity Female Hispanic Americans Humans Intubation Male Middle Aged Mortality Non-intubated Normal distribution Oxygen Inhalation Therapy Pandemics Patient positioning Patients Positioning Prone Position Respiratory Distress Syndrome - etiology Respiratory Distress Syndrome - mortality Respiratory Distress Syndrome - therapy Respiratory failure Severe acute respiratory syndrome coronavirus 2 Statistical analysis Survival analysis Time-to-Treatment Ventilators Wakefulness
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Zusammenfassung:	Awake prone positioning (APP) is widely used in the management of patients with coronavirus disease (COVID-19). The primary objective of this study was to compare the outcome of COVID-19 patients who received early versus late APP. Post hoc analysis of data collected for a randomized controlled trial (ClinicalTrials.gov NCT04325906). Adult patients with acute hypoxemic respiratory failure secondary to COVID-19 who received APP for at least one hour were included. Early prone positioning was defined as APP initiated within 24 h of high-flow nasal cannula (HFNC) start. Primary outcomes were 28-day mortality and intubation rate. We included 125 patients (79 male) with a mean age of 62 years. Of them, 92 (73.6%) received early APP and 33 (26.4%) received late APP. Median time from HFNC initiation to APP was 2.25 (0.8-12.82) vs 36.35 (30.2-75.23) hours in the early and late APP group (p
ISSN:	1364-8535 1466-609X 1364-8535 1366-609X
DOI:	10.1186/s13054-021-03761-9