{"id":26790,"date":"2024-11-03T04:16:00","date_gmt":"2024-11-02T20:16:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=26790"},"modified":"2024-11-03T05:53:07","modified_gmt":"2024-11-02T21:53:07","slug":"intensive-care-med%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%96%b0%e5%86%a0%e8%82%ba%e7%82%8e%e5%90%88%e5%b9%b6%e6%80%a5%e6%80%a7%e5%91%bc%e5%90%b8%e5%8a%9f%e8%83%bd%e8%a1%b0%e7%ab%ad%e6%82%a3","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=26790","title":{"rendered":"[Intensive Care Med\u53d1\u8868\u8bba\u6587]\uff1a\u65b0\u51a0\u80ba\u708e\u5408\u5e76\u6025\u6027\u547c\u5438\u529f\u80fd\u8870\u7aed\u60a3\u8005\u7684\u957f\u7a0b\u4e0e\u77ed\u7a0b\u6e05\u9192\u4fef\u5367\u4f4d"},"content":{"rendered":"\n

Prolonged vs shorter awake prone positioning for COVID-19 patients with acute respiratory failure: a multicenter, randomised controlled trial<\/h1>\n\n\n\n

Liu, L., Sun, Q., Zhao, H.\u00a0et al.<\/em><\/h3>\n\n\n\n

Intensive Care Med<\/em>\u00a050<\/strong>, 1298\u20131309 (2024)<\/h3>\n\n\n\n

https:\/\/doi.org\/10.1007\/s00134-024-07545-x<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Purpose<\/h3>\n\n\n\n

Awake prone positioning has been reported to reduce endotracheal intubation in patients with coronavirus disease 2019 (COVID-19)-related acute hypoxemic respiratory failure (AHRF). However, it is still unclear whether using the awake prone positioning for longer periods can further improve outcomes.<\/p>\n\n\n\n

Methods<\/h3>\n\n\n\n

In this randomized, open-label clinical trial conducted at 12 hospitals in China, non-intubated patients with COVID-19-related AHRF were randomly assigned to prolonged awake prone positioning (target\u2009>\u200912 h daily for 7 days) or standard care with a shorter period of awake prone positioning. The primary outcome was endotracheal intubation within 28 days after randomization. The key secondary outcomes included mortality and adverse events.<\/p>\n\n\n\n

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

In total, 409 patients were enrolled and randomly assigned to prolonged awake prone positioning (n<\/em>\u2009=\u2009205) or standard care (n<\/em>\u2009=\u2009204). In the first 7\u00a0days after randomization, the median duration of prone positioning was 12\u00a0h\/d (interquartile range [IQR] 12\u201314\u00a0h\/d) in the prolonged awake prone positioning group vs. 5\u00a0h\/d (IQR 2\u20138\u00a0h\/d) in the standard care group. In the intention-to-treat analysis, intubation occurred in 35 (17%) patients assigned to prolonged awake prone positioning and in 56 (27%) patients assigned to standard care (relative risk 0.62 [95% confidence interval (CI) 0.42\u20130.9]). The hazard ratio (HR) for intubation was 0.56 (0.37\u20130.86), and for mortality was 0.63 (0.42\u20130.96) for prolonged awake prone positioning versus standard care, within 28\u00a0days. The incidence of pre-specified adverse events was low and similar in both groups.<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusion<\/h3>\n\n\n\n

Prolonged awake prone positioning of patients with COVID-19-related AHRF reduces the intubation rate without significant harm. These results support prolonged awake prone positioning of patients with COVID-19-related AHRF.<\/p>\n","protected":false},"excerpt":{"rendered":"

Prolonged vs shorter awake prone positioning for COVID- […]<\/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\/26790"}],"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=26790"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26790\/revisions"}],"predecessor-version":[{"id":26791,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26790\/revisions\/26791"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26790"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26790"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26790"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}