Associations of Awake Prone Positioning-Induced Changes in Physiology with Intubation

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 prog...

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Detalles Bibliográficos
Autores: Morales-Quinteros, Luis|||0000-0002-8937-9824, Scala, Raffaele|||0000-0001-6448-8437, Silva, João Manoel, Leidi, Antonio, Leszek, Alexandre, Vazquez-Guillamet, Rodrigo, Pascual-Guardia, Sergi|||0000-0002-6567-0916, Serpa-Neto, Ary, Artigas Raventós, Antoni|||0000-0002-8029-1017, Schultz, Marcus J.|||0000-0003-3969-7792
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:290173
Acceso en línea:https://ddd.uab.cat/record/290173
https://dx.doi.org/urn:doi:10.1007/s41030-023-00242-y
Access Level:acceso abierto
Palabra clave:Acute hypoxemic respiratory failure
Awake prone position
Coronavirus disease
COVID-19
Intubation
Prognostication
Self-proning
Descripción
Sumario: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

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