Show simple item record

 
dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorIbarra-Estrada, Miguel
dc.contributor.authorLi, Jie
dc.contributor.authorPavlov, Ivan
dc.contributor.authorPerez, Yonatan
dc.contributor.authorRoca Gas, Oriol
dc.contributor.authorTavernier, Elsa
dc.date.accessioned2022-08-12T09:52:46Z
dc.date.available2022-08-12T09:52:46Z
dc.date.issued2022-03-28
dc.identifier.citationIbarra-Estrada M, Li J, Pavlov I, Perez Y, Roca O, Tavernier E, et al. Factors for success of awake prone positioning in patients with COVID-19-induced acute hypoxemic respiratory failure: analysis of a randomized controlled trial. Crit Care. 2022 Mar 28;26:84.
dc.identifier.issn1466-609X
dc.identifier.urihttp://hdl.handle.net/11351/8000
dc.descriptionAcute hypoxemic respiratory failure; COVID-19; Intubation
dc.description.abstractBackground Awake prone positioning (APP) improves oxygenation in coronavirus disease (COVID-19) patients and, when successful, may decrease the risk of intubation. However, factors associated with APP success remain unknown. In this secondary analysis, we aimed to assess whether APP can reduce intubation rate in patients with COVID-19 and to focus on the factors associated with success. Methods In this multicenter randomized controlled trial, conducted in three high-acuity units, we randomly assigned patients with COVID-19-induced acute hypoxemic respiratory failure (AHRF) requiring high-flow nasal cannula (HFNC) oxygen to APP or standard care. Primary outcome was intubation rate at 28 days. Multivariate analyses were performed to identify the predictors associated to treatment success (survival without intubation). Results Among 430 patients randomized, 216 were assigned to APP and 214 to standard care. The APP group had a lower intubation rate (30% vs 43%, relative risk [RR] 0.70; CI95 0.54–0.90, P = 0.006) and shorter hospital length of stay (11 interquartile range [IQR, 9–14] vs 13 [IQR, 10–17] days, P = 0.001). A respiratory rate ≤ 25 bpm at enrollment, an increase in ROX index > 1.25 after first APP session, APP duration > 8 h/day, and a decrease in lung ultrasound score ≥ 2 within the first 3 days were significantly associated with treatment success for APP. Conclusion In patients with COVID-19-induced AHRF treated by HFNC, APP reduced intubation rate and improved treatment success. A longer APP duration is associated with APP success, while the increase in ROX index and decrease in lung ultrasound score after APP can also help identify patients most likely to benefit.
dc.language.isoeng
dc.publisherBMC
dc.relation.ispartofseriesCritical Care;26
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectInsuficiència respiratòria - Tractament
dc.subjectCOVID-19 (Malaltia) - Complicacions
dc.subject.meshRespiratory Insufficiency
dc.subject.mesh/therapy
dc.subject.meshCoronavirus Infections
dc.subject.mesh/complications
dc.titleFactors for success of awake prone positioning in patients with COVID-19-induced acute hypoxemic respiratory failure: analysis of a randomized controlled trial
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.1186/s13054-022-03950-0
dc.subject.decsinsuficiencia respiratoria
dc.subject.decs/terapia
dc.subject.decsinfecciones por Coronavirus
dc.subject.decs/complicaciones
dc.relation.publishversionhttps://doi.org/10.1186/s13054-022-03950-0
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Ibarra-Estrada M] Unidad de Terapia Intensiva, Hospital Civil Fray Antonio Alcalde, Jalisco, Mexico. [Li J] Department of Cardio pulmonary Sciences, Division of Respiratory Care, Rush University, Chicago, IL, USA. [Pavlov I] Department of Emergency Medicine, Hôpital de Verdun, Montréal, Québec, Canada. [Perez Y] CHRU Tours, Médecine Intensive Réanimation, CIC INSERM 1415, CRICS-TriggerSep FCRIN Research Network, Tours, France. [Roca O] Unitat de Cures Intensives, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Ciber Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. [Tavernier E] Clinical Investigation Center, INSERM 1415, CHRU Tours, Tours, France. Methods in Patients Centered Outcomes and Health Research, INSERM, UMR 1246, Nantes, France
dc.identifier.pmid35346319
dc.identifier.wos000778606300001
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record