{"id":24411,"date":"2023-08-20T04:54:00","date_gmt":"2023-08-19T20:54:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24411"},"modified":"2023-08-20T06:26:51","modified_gmt":"2023-08-19T22:26:51","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%b0%94%e7%ae%a1%e6%8f%92%e7%ae%a1%e7%9a%84%e6%96%b0%e5%86%a0%e8%82%ba%e7%82%8e%e6%82%a3%e8%80%85%e9%95%bf%e6%97%b6%e9%97%b4%e4%bf%af%e5%8d%a7","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24411","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u6c14\u7ba1\u63d2\u7ba1\u7684\u65b0\u51a0\u80ba\u708e\u60a3\u8005\u957f\u65f6\u95f4\u4fef\u5367\u4f4d\u901a\u6c14\u4f34\u968f\u75c5\u6b7b\u7387\u964d\u4f4e"},"content":{"rendered":"\n

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 163, ISSUE 3<\/a>, P533-542, MARCH 2023Download Full Issue<\/p>\n\n\n\n

Prolonged Prone Position Ventilation Is Associated With Reduced Mortality in Intubated COVID-19 Patients<\/h1>\n\n\n\n

Daniel Okin, Ching-Ying Huang, George A. Alba, et al<\/h3>\n\n\n\n

Chest 2023; 163: 533-542 Published:November 04, 2022<\/h3>\n\n\n\n

DOI:https:\/\/doi.org\/10.1016\/j.chest.2022.10.034<\/a><\/h3>\n\n\n\n

Background<\/h3>\n\n\n\n

Prone position ventilation (PPV) is resource-intensive, yet the optimal strategy for PPV in intubated patients with COVID-19 is unclear.<\/p>\n\n\n\n

Research Question<\/h3>\n\n\n\n

Does a prolonged (24 or more h) PPV strategy improve mortality in intubated COVID-19 patients compared with intermittent (\u223c16 h with daily supination) PPV?<\/p>\n\n\n\n

Study Design and Methods<\/h3>\n\n\n\n

Multicenter, retrospective cohort study of consecutively admitted intubated COVID-19 patients treated with PPV between March 11 and May 31, 2020. The primary outcome was 30-day all-cause mortality. Secondary outcomes included 90-day all-cause mortality and prone-related complications. Inverse probability treatment weights (IPTW) were used to control for potential treatment selection bias.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

Of the COVID-19 patients who received PPV, 157 underwent prolonged and 110 underwent intermittent PPV. Patients undergoing prolonged PPV had reduced 30-day (adjusted hazard ratio [aHR], 0.475; 95%\u00a0CI, 0.336-0.670;\u00a0P<\/em>\u00a0< .001) and 90-day (aHR, 0.638; 95%\u00a0CI, 0.461-0.883;\u00a0P<\/em>\u00a0= .006) mortality compared with intermittent PPV. In patients with Pao2<\/sub>\/Fio2<\/sub>\u00a0\u2264 150 at the time of pronation, prolonged PPV was associated with reduced 30-day (aHR, 0.357; 95%\u00a0CI, 0.213-0.597;\u00a0P<\/em>\u00a0< .001) and 90-day mortality (aHR, 0.562; 95%\u00a0CI, 0.357-0.884;\u00a0P<\/em>\u00a0= .008). Patients treated with prolonged PPV underwent fewer pronation and supination events (median, 1; 95%\u00a0CI, 1-2 vs\u00a03; 95%\u00a0CI, 1-4;\u00a0P<\/em>\u00a0< .001). PPV strategy was not associated with overall PPV-related complications, although patients receiving prolonged PPV had increased rates of facial edema and lower rates of peri-proning hypotension.<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

Among intubated COVID-19 patients who received PPV, prolonged PPV was associated with reduced mortality. Prolonged PPV was associated with fewer pronation and supination events and a small increase in rates of facial edema. These findings suggest that prolonged PPV is a safe, effective strategy for mortality reduction in intubated COVID-19 patients.<\/p>\n","protected":false},"excerpt":{"rendered":"

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 163, ISSU […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24411"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24411"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24411\/revisions"}],"predecessor-version":[{"id":24412,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24411\/revisions\/24412"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24411"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24411"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24411"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}