Practice of Awake Prone Positioning in Critically Ill COVID-19 Patients-Insights from the PRoAcT-COVID Study
Stilma, Willemke (Amsterdam University of Applied Sciences)
Valk, Christel M. A. (Amsterdam UMC. University Medical Center)
van Meenen, David M. P. (Amsterdam UMC. University Medical Center)
Morales, Luis (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Remmelzwaal, Daantje (Amsterdam UMC. University Medical Center)
Myatra, Sheila N. (Homi Bhabha National Institute)
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Neto, Ary Serpa (Hospital Israelita Albert Einstein (Sao Paolo, Brasil))
Paulus, Frederique (Amsterdam University of Applied Sciences)
Schultz, Marcus J. (Mahidol University)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	We describe the incidence, practice and associations with outcomes of awake prone positioning in patients with acute hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19) in a national multicenter observational cohort study performed in 16 intensive care units in the Netherlands (PRoAcT-COVID-study). Patients were categorized in two groups, based on received treatment of awake prone positioning. The primary endpoint was practice of prone positioning. Secondary endpoint was 'treatment failure', a composite of intubation for invasive ventilation and death before day 28. We used propensity matching to control for observed confounding factors. In 546 patients, awake prone positioning was used in 88 (16. 1%) patients. Prone positioning started within median 1 (0 to 2) days after ICU admission, sessions summed up to median 12. 0 (8. 4-14. 5) hours for median 1. 0 day. In the unmatched analysis (HR, 1. 80 (1. 41-2. 31); p < 0. 001), but not in the matched analysis (HR, 1. 17 (0. 87-1. 59); p = 0. 30), treatment failure occurred more often in patients that received prone positioning. The findings of this study are that awake prone positioning was used in one in six COVID-19 patients. Prone positioning started early, and sessions lasted long but were often discontinued because of need for intubation.
Drets:	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, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Acute hypoxemic respiratory failure ; Awake prone positioning ; Coronavirus disease 2019 ; COVID-19 ; Outcome ; Prone positioning ; Propensity matching ; Self-proning
Publicat a:	Journal of clinical medicine, Vol. 11 (november 2022) , ISSN 2077-0383

DOI: 10.3390/jcm11236988
PMID: 36498564

12 p, 770.3 KB

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