Awake prone positioning in acute hypoxaemic respiratory failure: An international expert guidance
Background: Awake prone positioning (APP) of non-intubated patients with acute hypoxaemic respiratory failure (AHRF) has been inconsistently adopted into routine care of patients with COVID-19, likely due to apparent conflicting evidence from recent trials. This short guideline aims to provide evide...
| Autores: | , , , , , , , , , , , , , , , , |
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| Formato: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2023 |
| País: | España |
| Recursos: | Institut d'Investigació i Innovació Parc Taulí (I3PT) |
| Repositorio: | r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
| OAI Identifier: | oai:i3pt.fundanetsuite.com:p4151 |
| Acesso em linha: | https://i3pt.portalinvestigacion.com/publicaciones/4151 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85168737793&doi=10.1016%2fj.jcrc.2023.154401&partnerID=40&md5=3a66e0044f377b501d8332257826fab8 |
| Access Level: | acceso abierto |
| Palavra-chave: | COVID-19 Awake prone positioning Prone position Acute hypoxaemic respiratory failure Guideline High flow nasal cannula Oxygen therapy Non-invasive ventilation |
| Resumo: | Background: Awake prone positioning (APP) of non-intubated patients with acute hypoxaemic respiratory failure (AHRF) has been inconsistently adopted into routine care of patients with COVID-19, likely due to apparent conflicting evidence from recent trials. This short guideline aims to provide evidence-based recommendations for the use of APP in various clinical scenarios.Methods: An international multidisciplinary panel, assembled for their expertise and representativeness, and supported by a methodologist, performed a systematic literature search, summarized the available evidence derived from randomized clinical trials, and developed recommendations using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology.Results: The panel strongly recommends that APP rather than standard supine care be used in patients with COVID-19 receiving advanced respiratory support (high-flow nasal cannula, continuous positive airway pressure or non-invasive ventilation). Due to lack of evidence from randomized controlled trials, the panel provides no recommendation on the use of APP in patients with COVID-19 supported with conventional oxygen therapy, nor in patients with AHRF due to causes other than COVID-19.Conclusion: APP should be routinely implemented in patients with COVID-19 receiving advanced respiratory support. |
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