Observational studyIntensive care medicine2018
A prospective international observational prevalence study on prone positioning of ARDS patients: the APRONET (ARDS Prone Position Network) study.
Observational study in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 137 papers, 4 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.
Risk Assessment of Ventilator-induced Lung Injury in Patients With Acute Respiratory Distress Syndrome: The Role of Morphological Phenotype in ARDS
Evaluation of Tidal Volume Challenge to Detect Preload-responsiveness in Patients With Acute Respiratory Distress Syndrome (ARDS) During Prone Position
Pulmonary Imaging-based Postural Ventilation in Patients With Severe COVID-19 - a Prospective, Non-randomized Controlled Study
Who cites it
137 citing papers in PubMed, 4 syntheses or guidelines pooled it, 301 citations in OpenAlex.
- Definition and prognostic value of response to prone positioning in ARDS: a systematic review and meta-analysis.Critical care (London, England) · 2026Pooled it
- Prone positioning during veno-venous extracorporeal membrane oxygenation: a systematic review and meta-analysis.Intensive care medicine · 2025Pooled it
- Long-term complications of prone position ventilation with relevance for acute and postacute rehabilitation: a systematic review of the literature.European journal of physical and rehabilitation medicine · 2023Pooled it
- Higher PEEP improves outcomes in ARDS patients with clinically objective positive oxygenation response to PEEP: a systematic review and meta-analysis.BMC anesthesiology · 2018Pooled it
- Optimal Prone Position Duration in Patients With ARDS Due to COVID-19: The Omelette Pilot Trial.Respiratory care · 2024Trial
- Impact of take-home messages written into slide presentations delivered during lectures on the retention of messages and the residents' knowledge: a randomized controlled study.BMC medical education · 2020Trial
- Prone positioning in ARDS.Intensive care medicine · 2026Review
- Prone Positioning in a North American Cohort of Hypoxemic Patients on Mechanical Ventilation.Critical care medicine · 2026Observational
- Time-dependent effects in consecutive cycles of prone positioning for acute respiratory failure: insights from the PROVENT-C19 Registry.Journal of anesthesia, analgesia and critical care · 2026Article
- Prone Positioning in a North American Cohort of Hypoxemic Patients on Mechanical Ventilation.medRxiv : the preprint server for health sciences · 2025Article
- Role of Attending Practice Variability in Prone Positioning Initiation: A Retrospective Cohort Study.CHEST critical care · 2025Article
- Point-of-care Lung ultrasound assessment of positional changes in COVID-19 ARDS in intensive care: A case report and review of the literature.Physiological reports · 2025Review
- Association between ventilation-perfusion matching improvement during initial prone positioning and ICU mortality in patients with moderate to severe ARDS: a prospective two-center study.Annals of intensive care · 2025Article
- Time-dependent effects of prone position on ventilation-perfusion matching assessed by electrical impedance tomography in patients with COVID-19 ARDS: sub-analysis of a prospective physiological study.Annals of intensive care · 2025Article
- Novel magnetic resonance imaging methodology for dynamic visualization of respiratory thoracic motion: a pilot feasibility study.Frontiers in rehabilitation sciences · 2025Article
- Prone position ventilation-induced oxygenation improvement as a valuable predictor of survival in patients with acute respiratory distress syndrome: a retrospective observational study.BMC pulmonary medicine · 2024Observational
- The Five Pillars of Acute Right Ventricular Heart Failure Therapy: Can We Keep the Pediment in Balance?Journal of clinical medicine · 2024Article
- Influenza A Infection With Virus-Associated Pneumonia and Hemorrhagic Shock and Encephalopathy Syndrome in an Adult.Cureus · 2024Article
- Extended versus Standard Proning Duration for COVID-19-associated Acute Respiratory Distress Syndrome: A Target Trial Emulation Study.Annals of the American Thoracic Society · 2024Article
- Epidemiology, ventilation management and outcomes of COVID-19 ARDS patients versus patients with ARDS due to pneumonia in the Pre-COVID era.Respiratory research · 2024Observational
77 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
26 authors at 20 institutions in 14 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWhile prone positioning (PP) has been shown to improve patient survival in moderate to severe acute respiratory distress syndrome (ARDS) patients, the rate of application of PP in clinical practice still appears low.
aimThis study aimed to determine the prevalence of use of PP in ARDS patients (primary endpoint), the physiological effects of PP, and the reasons for not using it (secondary endpoints).
methodsThe APRONET study was a prospective international 1-day prevalence study performed four times in April, July, and October 2016 and January 2017. On each study day, investigators in each ICU had to screen every patient. For patients with ARDS, use of PP, gas exchange, ventilator settings and plateau pressure (Pplat) were recorded before and at the end of the PP session. Complications of PP and reasons for not using PP were also documented. Values are presented as median (1st-3rd quartiles).
resultsOver the study period, 6723 patients were screened in 141 ICUs from 20 countries (77% of the ICUs were European), of whom 735 had ARDS and were analyzed. Overall 101 ARDS patients had at least one session of PP (13.7%), with no differences among the 4 study days. The rate of PP use was 5.9% (11/187), 10.3% (41/399) and 32.9% (49/149) in mild, moderate and severe ARDS, respectively (P = 0.0001). The duration of the first PP session was 18 (16-23) hours. Measured with the patient in the supine position before and at the end of the first PP session, PaO
conclusionsIn conclusion, this prospective international prevalence study found that PP was used in 32.9% of patients with severe ARDS, and was associated with low complication rates, significant increase in oxygenation and a significant decrease in driving pressure.
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Registered trials
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.