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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)

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ESPERATTI, Mariano, BUSICO, Marina, FUENTES, Nora angélica, GALLARDO, Adrian, OSATNIK, Javier, VITALI, Alejandra, WASINGER, Elizabeth gisele, OLMOS, Matías, QUINTANA, Jorgelina, SAAVEDRA, Santiago nicolas, LAGAZIO, Ana inés, ANDRADA, Facundo juan, KAKISU, Hiromi, ESTEBAN ROMANO, Nahuel, MATARRESE, Agustin, MOGADOURO, Mariela adriana, MAST, Giuliana, NAVARRO MORENO, Claudia, REBAZA NIQUIN, Greta dennise, BARBARESI, Veronica, BRUHN CRUZ, Alejandro, FERREYRO, Bruno leonel, TORRES MARTÍ, Antoni, Argentine Collaborative Group on High Flow and Pro. 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, núm. 1, pàgs. 16-25. [consulta: 25 de febrer de 2026]. ISSN: 1364-8535. [Disponible a: https://hdl.handle.net/2445/185982]

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