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2022-01-07

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cc-by (c) Esperatti, Mariano et al., 2022
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/185982

Impact of exposure time in awake prone positioning on clinical outcomes of patients with COVID-19-related acute respiratory failure treated with high-flow nasal oxygen: a multicenter cohort study

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https://doi.org/10.1186/s13054-021-03881-2

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Abstract Background: In patients with COVID-19-related acute respiratory failure (ARF), awake prone positioning (AW-PP) reduces the need for intubation in patients treated with high-fow nasal oxygen (HFNO). However, the efects of different exposure times on clinical outcomes remain unclear. We evaluated the efect of AW-PP on the risk of endotracheal intubation and in-hospital mortality in patients with COVID-19-related ARF treated with HFNO and analyzed the efects of diferent exposure times to AW-PP. Methods: This multicenter prospective cohort study in six ICUs of 6 centers in Argentine consecutively included patients>18 years of age with confrmed COVID-19-related ARF requiring HFNO from June 2020 to January 2021. In the primary analysis, the main exposure was awake prone positioning for at least 6 h/day, compared to non-prone positioning (NON-PP). In the sensitivity analysis, exposure was based on the number of hours receiving AW-PP. Inverse probability weighting-propensity score (IPW-PS) was used to adjust the conditional probability of treatment assignment. The primary outcome was endotracheal intubation (ETI); and the secondary outcome was hospital mortality. Results: During the study period, 580 patients were screened and 335 were included; 187 (56%) tolerated AW-PP for [median (p25-75)] 12 (9-16) h/day and 148 (44%) served as controls. The IPW-propensity analysis showed standardized diferences<0.1 in all the variables assessed. After adjusting for other confounders, the OR (95% CI) for ETI in the AW-PP group was 0.36 (0.2-0.7), with a progressive reduction in OR as the exposure to AW-PP increased. The adjusted

Matèries

COVID-19, Insuficiència respiratòria, Intubació, Posicions dels malalts, Oxigenoteràpia, Mortalitat

Matèries (anglès)

COVID-19, Respiratory insufficiency, Intubation, Positioning of patients, Oxygen therapy, Mortality

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Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

ESPERATTI, Mariano, et al. Impact of exposure time in awake prone positioning on clinical outcomes of patients with COVID-19-related acute respiratory failure treated with high-flow nasal oxygen: a multicenter cohort study. Critical Care. 2022. Vol. 26, num. 1, pags. 16-25. ISSN 1364-8535. [consulted: 28 of May of 2026]. Available at: https://hdl.handle.net/2445/185982

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