Practice of Awake Prone Positioning in Critically Ill COVID-19 Patients-Insights from the PRoAcT-COVID Study

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.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:11

Enthalten in:

Journal of clinical medicine - 11(2022), 23 vom: 26. Nov.

Sprache:

Englisch

Beteiligte Personen:

Stilma, Willemke [VerfasserIn]
Valk, Christel M A [VerfasserIn]
van Meenen, David M P [VerfasserIn]
Morales, Luis [VerfasserIn]
Remmelzwaal, Daantje [VerfasserIn]
Myatra, Sheila N [VerfasserIn]
Artigas, Antonio [VerfasserIn]
Neto, Ary Serpa [VerfasserIn]
Paulus, Frederique [VerfasserIn]
Schultz, Marcus J [VerfasserIn]
PRoAcT–COVID Collaborative Group [VerfasserIn]
Aydeniz, E [Sonstige Person]
van de Berg, P [Sonstige Person]
Bergmans, D C [Sonstige Person]
Bevers, M [Sonstige Person]
den Boer, S [Sonstige Person]
Boers, L S [Sonstige Person]
Bos, L D J [Sonstige Person]
Botta, M [Sonstige Person]
Buiteman-Kruizinga, L A [Sonstige Person]
Coene, W [Sonstige Person]
Delmte, M [Sonstige Person]
Di Leo, V [Sonstige Person]
Dongelmans, D A [Sonstige Person]
Dormans, T P [Sonstige Person]
Elting, L M [Sonstige Person]
Esmeijer, A A [Sonstige Person]
Gama de Abreu, M [Sonstige Person]
Girbes, A R [Sonstige Person]
de Graaff, M J [Sonstige Person]
Go, D M [Sonstige Person]
Goossen, R L [Sonstige Person]
Hansen, H J [Sonstige Person]
Haringman, J J [Sonstige Person]
van der Heiden, P L [Sonstige Person]
Hol, L [Sonstige Person]
Hollmann, M W [Sonstige Person]
Horn, J [Sonstige Person]
van Ingen, L E [Sonstige Person]
Juffermans, N P [Sonstige Person]
Koornstra, E [Sonstige Person]
Kuiper, M A [Sonstige Person]
Kuipers, L J [Sonstige Person]
Lokhorst, A [Sonstige Person]
Martin–Loeches, I [Sonstige Person]
Mazzinari, G [Sonstige Person]
Myatra, S N [Sonstige Person]
Nijbroek, G S L H [Sonstige Person]
Offermans, M [Sonstige Person]
van Oosten, P [Sonstige Person]
Paulus, F [Sonstige Person]
Pisters, T [Sonstige Person]
Prins, A [Sonstige Person]
Pillay, J [Sonstige Person]
Purmer, I M [Sonstige Person]
Rezaee, A S [Sonstige Person]
Rettig, T C D [Sonstige Person]
Roca, O [Sonstige Person]
Rosenberg, N M [Sonstige Person]
Schavemaker, N [Sonstige Person]
Schultz, M J [Sonstige Person]
Sciascera, A A [Sonstige Person]
Serpa Neto, A [Sonstige Person]
Sherstha, G [Sonstige Person]
Sleeswijk, M E [Sonstige Person]
Spronk, P E [Sonstige Person]
Stilma, W [Sonstige Person]
Strang, A C [Sonstige Person]
Tsonas, A M [Sonstige Person]
Tuinman, P R [Sonstige Person]
Valk, C M A [Sonstige Person]
Verboom, M [Sonstige Person]
Vlaar, A P [Sonstige Person]
van Velzen, P [Sonstige Person]
van der Ven, W H [Sonstige Person]
van der Ven, F L [Sonstige Person]
Verhoef, E J [Sonstige Person]
Vermeulen, T D [Sonstige Person]
van Vliet, P [Sonstige Person]
Voorham, J J J S [Sonstige Person]
van der Voort, P H [Sonstige Person]
Weiner, N [Sonstige Person]
Yaali, N [Sonstige Person]
Zandvliet, J M [Sonstige Person]
van Zanten, A R [Sonstige Person]
van Zijl, T Z [Sonstige Person]
Zonneveld, S A [Sonstige Person]

Links:

Volltext

Themen:

Acute hypoxemic respiratory failure
Awake prone positioning
COVID-19
Coronavirus disease 2019
Journal Article
Outcome
Prone positioning
Propensity matching
Self-proning

Anmerkungen:

Date Revised 08.03.2023

published: Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.3390/jcm11236988

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM350107718