Evidence map›Paper›PMID 33169218›Full record

ReviewIntensive care medicine2020

Prone position in ARDS patients: why, when, how and for whom.

Claude Guérin, Richard K Albert, Jeremy Beitler, Luciano Gattinoni, Samir Jaber, John J Marini, Laveena Munshi, Laurent Papazian, Antonio Pesenti, Antoine Vieillard-Baron and 1 more

Registry-linked trialOpen access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Intensive care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06181539 (Evaluate the Effect of Prone Ventilation on Ventilated-blood Flow Ratio in Patients With Acute Respiratory Distress Syndrome by Electrical Impedance Tomography), which is not on this map. Cited by 240 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
240citing papers in PubMed, 14 pooled it
43.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT06181539 completednot on this mapstarted 2023, after this paper: background citation

Evaluate the Effect of Prone Ventilation on Ventilated-blood Flow Ratio in Patients With Acute Respiratory Distress Syndrome by Electrical Impedance Tomography

TypeobservationalSponsorUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyRan2023 to 2025Enrolled94ConditionsAcute Respiratory Distress Syndrome, Electrical Impedance Tomography, Prone Position Ventilation, Ventilation Perfusion Mismatch
3 · Its place in the literature

Who cites it

240 citing papers in PubMed, 14 syntheses or guidelines pooled it, 530 citations in OpenAlex.

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180 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 11 institutions in 6 countries.

Claude GuérinMédecine Intensive-Réanimation, Hôpital Edoudard Herriot, Lyon, France.ORCID http://orcid.org/0000-0003-4700-6672
Richard K AlbertDepartment of Medicine, University of Colorado, Aurora, USA.
Jeremy BeitlerCenter for Acute Respiratory Failure and Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Luciano GattinoniDepartment of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Göttingen, Germany.
Samir JaberCritical Care and Anesthesia Department (DAR B), Hôpital Saint-Éloi, CHU de Montpellier, PhyMedExp, Université de Montpellier, Montpellier, France.
John J MariniDepartments of Critical Care Medicine, Regions Hospital and University of Minnesota, Minneapolis-St. Paul, USA.
Laveena MunshiInterdepartmental Division of Critical Care Medicine, Mount Sinai Hospital, Sinai Health System, University of Toronto, Toronto, Canada.
Laurent PapazianMédecine Intensive Réanimation, Assistance Publique, Hôpitaux de Marseille, Hôpital Nord, 13015, Marseille, France.
Antonio PesentiDipartimento Di Anestesia, Rianimazione ed Emergenza Urgenza, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy.
Antoine Vieillard-BaronUniversity Hospital Ambroise Paré, APHP, Boulogne-Billancourt, and Université de Versailles Saint Quentin en Yvelines UMR 1018, Boulogne-Billancourt, France.
Jordi ManceboServei Medicina Intensiva, Hospital Universitari Sant Pau, Barcelona, Spain. jmancebo@santpau.cat.ORCID http://orcid.org/0000-0003-3308-5410
Assistance Publique Hôpitaux de Marseille · FRColumbia University · USFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico · ITHospital de Sant Pau · ESInserm · FRMount Sinai Hospital · CARegions Hospital · USUniversité Claude Bernard Lyon 1 · FRUniversité de Versailles Saint-Quentin-en-Yvelines · FRUniversity of Colorado Anschutz Medical Campus · USUniversity of Göttingen · DE

Funding

Breath stacking dyssynchrony in acute respiratory distress syndromeK23HL133489 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BEITLER, JEREMY R. · 2017 to 2021
$871k
NHLBI NIH HHS K23 HL133489
6 · The paper itself

Abstract

In ARDS patients, the change from supine to prone position generates a more even distribution of the gas-tissue ratios along the dependent-nondependent axis and a more homogeneous distribution of lung stress and strain. The change to prone position is generally accompanied by a marked improvement in arterial blood gases, which is mainly due to a better overall ventilation/perfusion matching. Improvement in oxygenation and reduction in mortality are the main reasons to implement prone position in patients with ARDS. The main reason explaining a decreased mortality is less overdistension in non-dependent lung regions and less cyclical opening and closing in dependent lung regions. The only absolute contraindication for implementing prone position is an unstable spinal fracture. The maneuver to change from supine to prone and vice versa requires a skilled team of 4-5 caregivers. The most frequent adverse events are pressure sores and facial edema. Recently, the use of prone position has been extended to non-intubated spontaneously breathing patients affected with COVID-19 ARDS. The effects of this intervention on outcomes are still uncertain.

Indexed as

HumansLung ComplianceProne PositionRespiratory Distress SyndromeRespiratory MechanicsAcute respiratory distress syndromeGravityLung protective ventilationProne positionVentilation/perfusion

Identifiers

PMID33169218
PMCPMC7652705
OpenAlexW3100383641

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.