ArticleJournal of intensive care medicine2021
Prone Positioning in Moderate to Severe Acute Respiratory Distress Syndrome Due to COVID-19: A Cohort Study and Analysis of Physiology.
Article in Journal of intensive care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 6 of them syntheses that pooled it.
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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.
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Who cites it
68 citing papers in PubMed, 6 syntheses or guidelines pooled it, 173 citations in OpenAlex.
- Awake prone positioning for patients with COVID-19-related respiratory failure: a systematic review and meta-analysis.Internal and emergency medicine · 2024Pooled it
- Efficacy and safety of prone position in COVID-19 patients with respiratory failure: a systematic review and meta-analysis.European journal of medical research · 2022Pooled it
- Effect of prone versus supine position in COVID-19 patients: A systematic review and meta-analysis.Journal of clinical anesthesia · 2021Pooled it
- Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis.Scientific reports · 2021Pooled it
- Prone ventilation in intubated COVID-19 patients: a systematic review and meta-analysis.Brazilian journal of anesthesiology (Elsevier)Pooled it
- Prone Positioning in Patients With COVID-19: Analysis of Multicenter Registry Data and Meta-analysis of Aggregate Data.In vivo (Athens, Greece)Pooled it
- Awake prone positioning in patients with hypoxemic respiratory failure due to COVID-19: the PROFLO multicenter randomized clinical trial.Critical care (London, England) · 2021Trial
- Prone positioning in ARDS.Intensive care medicine · 2026Review
- [Effect of awake prone positioning in non-intubated patients with community-acquired pneumonia complicated by hypoxemia].Medecine tropicale et sante internationale · 2025Review
- Development and validation of a Knowledge, Attitude, and Practice Questionnaire Related to Prone Positioning among Intensive Care Unit Nurses.BMC nursing · 2025Article
- Impact of proning with and without inhaled pulmonary vasodilators and neuromuscular blocking agents in COVID acute respiratory distress syndrome.World journal of critical care medicine · 2025Article
- Characterization of Global Research Trends and Prospects on Prone Positioning in Respiratory Failure: Bibliometric Analysis.Interactive journal of medical research · 2025Article
- Article
- Effect of early and later prone positioning on outcomes in invasively ventilated COVID-19 patients with acute respiratory distress syndrome: analysis of the prospective COVID-19 critical care consortium cohort study.Annals of intensive care · 2025Article
- Influence of Prone Position on the Survival of COVID-19 Patients Undergoing Invasive Mechanical Ventilation: A Propensity Score Matching Study.International journal of general medicine · 2025Article
- Body Positions and Physical Activity Levels Modulate the Ratio of Abdominal to Thoracic Breathing and Respiratory Rate in Young Individuals.Journal of clinical medicine · 2024Article
- Use of Early Ketamine Sedation and Association With Clinical and Cost Outcomes Among Mechanically Ventilated Patients With COVID-19: A Retrospective Cohort Study.Critical care explorations · 2024Article
- Glenohumeral joint auto-fusion in a morbidly obese patient intubated for severe COVID-19 infection.JSES reviews, reports, and techniques · 2024Article
- Deep learning segmentation and registration-driven lung parenchymal volume and movement CT analysis in prone positioning.PloS one · 2024Article
- Effect of Fu Zheng Jie Du Formula on outcomes in patients with severe pneumonia receiving prone ventilation: a retrospective cohort study.Frontiers in pharmacology · 2024Article
8 more citing papers are in PubMed but not listed here.
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Authors and funding
14 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundCoronavirus disease 2019 (COVID-19) can lead to acute respiratory distress syndrome (ARDS) but it is unknown whether prone positioning improves outcomes in mechanically ventilated patients with moderate to severe ARDS due to COVID-19.
methodsA cohort study at a New York City hospital at the peak of the early pandemic in the United States, under crisis conditions. The aim was to determine the benefit of prone positioning in mechanically ventilated patients with ARDS due to COVID-19. The primary outcome was in-hospital death. Secondary outcomes included changes in physiologic parameters. Fine-Gray competing risks models with stabilized inverse probability treatment weighting (sIPTW) were used to determine the effect of prone positioning on outcomes. In addition, linear mixed effects models (LMM) were used to assess changes in physiology with prone positioning.
resultsOut of 335 participants who were intubated and mechanically ventilated, 62 underwent prone positioning, 199 met prone positioning criteria and served as controls and 74 were excluded. The intervention and control groups were similar at baseline. In multivariate-adjusted competing risks models with sIPTW, prone positioning was significantly associated with reduced mortality (SHR 0.61, 95% CI 0.46-0.80,
conclusionsProne positioning in patients with moderate to severe ARDS due to COVID-19 is associated with reduced mortality and improved physiologic parameters. One in-hospital death could be averted for every 8 patients treated. Replicating results and scaling the intervention are important, but prone positioning may represent an additional therapeutic option in patients with ARDS due to COVID-19.
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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.