Trial reportNeurocritical care2014
Does prone positioning increase intracranial pressure? A retrospective analysis of patients with acute brain injury and acute respiratory failure.
Trial report in Neurocritical care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 3 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- Guideline on positioning and early mobilisation in the critically ill by an expert panel.Intensive care medicine · 2024Guideline
- ECMO in adult patients with severe trauma: a systematic review and meta-analysis.European journal of medical research · 2023Pooled it
- Mechanical ventilation in aneurysmal subarachnoid hemorrhage: systematic review and recommendations.Critical care (London, England) · 2020Pooled it
- Prone Positioning in Neurocritical Care Patients with Invasive Intracranial Pressure Monitoring: A Systematic Review and Meta-analysis.Neurocritical care · 2026Article
- Mechanical ventilation in acute brain injury.Breathe (Sheffield, England) · 2026Review
- Balancing lung and brain: physiological strategies for ARDS management in acute brain injury.Intensive care medicine · 2026Review
- Acute management of spinal fractures: What you need to know.The journal of trauma and acute care surgery · 2026Review
- Bridging brain and lung: optimizing mechanical ventilation in acute brain injury.Journal of anesthesia, analgesia and critical care · 2025Review
- Head up, face down-a practical framework for proning brain-injured patients with ARDS.Intensive care medicine · 2025Article
- Article
- The effects of prone position on optic nerve sheath diameter and intraocular pressure in elective lumbar disc surgery.BMC anesthesiology · 2025Observational
- High-Grade Subarachnoid Hemorrhage - Beyond Guidelines.Neurologic clinics · 2025Review
- The effect of high lateral position on antibiotic exposure duration in patients with severe traumatic brain injury: a retrospective observational cohort study.Frontiers in medicine · 2025Article
- Organ crosstalk: brain-lung interaction.Frontiers in medicine · 2025Review
- A reduction method for anterior opening displacement in thoracolumbarvertebral fractures with diffuse idiopathic skeletal hyperostosis using the skull clamp-assisted position.Fukushima journal of medical science · 2024Article
- Article
- Positive end-expiratory pressure increases intracranial pressure but not pressure reactivity index in supine and prone positions: a porcine model study.Frontiers in medicine · 2024Article
- Suspected intracranial hypertension in COVID-19 patients with severe respiratory failure.PloS one · 2024Observational
- Evidence-based management of adult traumatic brain injury with raised intracranial pressure in intensive critical care unit at resource-limited settings: a literature review.Annals of medicine and surgery (2012) · 2023Review
- Respiratory challenges and ventilatory management in different types of acute brain-injured patients.Critical care (London, England) · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe objective of our trial was to obtain more comprehensive data on the risks and benefits of kinetic therapy in intensive care patients with intracerebral pathology.
methodsStandardized data of prone positioning in our NeuroIntensive Care Unit were collected from 2007 onward. A post hoc analysis of all available data was undertaken, with special consideration given to values of intracranial pressure (ICP), cerebral perfusion pressure (CPP) and oxygenation in correlation to prone (PP), or supine positioning (SP) of patients. Cases were considered eligible if kinetic therapy and ICP were documented. Prone positioning was performed in a 135° position for 8 h per treatment unit.
resultsA total of 115 patients treated with prone positioning from 2007 to 2013 were identified in our medical records. Of these, 29 patients received ICP monitoring. Overall, 119 treatment units of prone positioning with a mean duration of 2.5 days per patient were performed. The mean baseline ICP in SP was 9.5 ± 5.9 mmHg and was increased significantly during PP (p < 0.0001). There was no significant difference between CPP in SP (82 ± 14.5 mmHg) compared to PP (p > 0.05). ICP values >20 mmHg occurred more often during PP than SP (p < 0.0001) and were associated with significantly more episodes of decreased CPP <70 mmHg (p < 0.0022). The mean paO(2)/FiO(2) ratio (P/F ratio) was increased significantly in prone positioning of patients (p < 0.0001).
conclusionsThe analyzed data allow a more precise understanding of changes in ICP and oxygenation during prone positioning in patients with acute brain injury and almost normal baseline ICP. Our study shows a moderate, yet significant elevation of ICP during prone positioning. However, the achieved increase of oxygenation by far exceeded the changes in ICP. It is evident that continuous monitoring of cerebral pressure is required in this patient group.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.