Evidence map›Paper›PMID 35346319›Full record

Trial reportCritical care (London, England)2022

Factors for success of awake prone positioning in patients with COVID-19-induced acute hypoxemic respiratory failure: analysis of a randomized controlled trial.

Miguel Ibarra-Estrada, Jie Li, Ivan Pavlov, Yonatan Perez, Oriol Roca, Elsa Tavernier, Bairbre McNicholas, David Vines, Miguel Marín-Rosales, Alexandra Vargas-Obieta and 8 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04477655 (Prone Positioning in Non-intubated Patients With Severe COVID-19), which is not on this map. Cited by 47 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 11 pooled it
–field-weighted citation impact
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.

NCT04477655 nacompletednot on this map

Prone Positioning in Non-intubated Patients With Severe COVID-19: a Randomized Controlled Trial

TypeinterventionalSponsorHospital Civil de GuadalajaraRan2020 to 2021Enrolled430ConditionsCovid19ArmsAwake prone positioning, Standard oxygen therapy
3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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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

18 authors.

Miguel Ibarra-Estrada *Unidad de Terapia Intensiva, Hospital Civil Fray Antonio Alcalde, El Retiro, Coronel Calderón 777, Guadalajara, Jalisco, Mexico. drmiguelibarra@hotmail.com.ORCID 0000-0001-8914-4171
Jie Li *Department of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University, Chicago, IL, USA.
Ivan PavlovDepartment of Emergency Medicine, Hôpital de Verdun, Montréal, Québec, Canada.
Yonatan PerezCHRU Tours, Médecine Intensive Réanimation, CIC INSERM 1415, CRICS-TriggerSep FCRIN Research Network, Tours, France.
Oriol RocaServei de Medicina Intensiva, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Elsa TavernierClinical Investigation Center, INSERM 1415, CHRU Tours, Tours, France.
Bairbre McNicholasDepartment of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, National University of Ireland, Galway, Ireland.
David VinesDepartment of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University, Chicago, IL, USA.
Miguel Marín-RosalesServicio de Medicina Interna, Hospital General de Occidente, Guadalajara, Jalisco, Mexico.
Alexandra Vargas-ObietaUnidad de Terapia Intensiva, Hospital Civil Fray Antonio Alcalde, El Retiro, Coronel Calderón 777, Guadalajara, Jalisco, Mexico.
Roxana García-SalcidoDepartamento de Urgencias, Hospital Civil Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
Sara A Aguirre-DíazDepartamento de Enfermedades Infecciosas, Hospital Civil Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
José A López-PulgarínUnidad de Terapia Intensiva, Hospital Civil Fray Antonio Alcalde, El Retiro, Coronel Calderón 777, Guadalajara, Jalisco, Mexico.
Quetzalcóatl Chávez-PeñaUnidad de Terapia Intensiva, Hospital Civil Fray Antonio Alcalde, El Retiro, Coronel Calderón 777, Guadalajara, Jalisco, Mexico.
Julio C Mijangos-MéndezUnidad de Terapia Intensiva, Hospital Civil Fray Antonio Alcalde, El Retiro, Coronel Calderón 777, Guadalajara, Jalisco, Mexico.
Guadalupe Aguirre-AvalosUnidad de Terapia Intensiva, Hospital Civil Fray Antonio Alcalde, El Retiro, Coronel Calderón 777, Guadalajara, Jalisco, Mexico.
Stephan Ehrmann *CHRU Tours, Médecine Intensive Réanimation, CIC INSERM 1415, CRICS-TriggerSep FCRIN Research Network, Tours, France.
John G Laffey *Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, National University of Ireland, Galway, Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAwake prone positioning (APP) improves oxygenation in coronavirus disease (COVID-19) patients and, when successful, may decrease the risk of intubation. However, factors associated with APP success remain unknown. In this secondary analysis, we aimed to assess whether APP can reduce intubation rate in patients with COVID-19 and to focus on the factors associated with success.

methodsIn this multicenter randomized controlled trial, conducted in three high-acuity units, we randomly assigned patients with COVID-19-induced acute hypoxemic respiratory failure (AHRF) requiring high-flow nasal cannula (HFNC) oxygen to APP or standard care. Primary outcome was intubation rate at 28 days. Multivariate analyses were performed to identify the predictors associated to treatment success (survival without intubation).

resultsAmong 430 patients randomized, 216 were assigned to APP and 214 to standard care. The APP group had a lower intubation rate (30% vs 43%, relative risk [RR] 0.70; CI

conclusionIn patients with COVID-19-induced AHRF treated by HFNC, APP reduced intubation rate and improved treatment success. A longer APP duration is associated with APP success, while the increase in ROX index and decrease in lung ultrasound score after APP can also help identify patients most likely to benefit.

trial registrationThis study was retrospectively registered in ClinicalTrials.gov at July 20, 2021. Identification number NCT04477655. https://clinicaltrials.gov/ct2/show/NCT04477655?term=PRO-CARF&draw=2&rank=1.

Indexed as

COVID-19Respiratory InsufficiencyCannulaHumansProne PositionWakefulnessAcute hypoxemic respiratory failureAwake prone positioningCOVID-19Intubation

Identifiers

PMID35346319
PMCPMC8958810

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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.