ArticleCritical care (London, England)2022
Lung response to prone positioning in mechanically-ventilated patients with COVID-19.
Article in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 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
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Awake prone positioning for non-intubated patients with COVID-19-related acute hypoxic respiratory failure: a systematic review based on eight high-quality randomized controlled trials.BMC infectious diseases · 2023Pooled 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
- Awake Prone Positioning in Non-Intubated Non-COVID-19 ARDS: A Comprehensive Review.Advances in respiratory medicine · 2026Review
- Right ventricular-protective ventilation in acute respiratory distress syndrome: phenotypes, monitoring and ventilatory management.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- hucMSCs alleviate LPS-induced endothelial glycocalyx damage by secreting Cxcl12 to activate CXCR4.Stem cell research & therapy · 2026Article
- Predicting early prone position ventilation responsiveness in patients with acute respiratory distress syndrome based on electrical impedance tomography: a prospective study.Critical care (London, England) · 2025Observational
- Enhanced glomerular thrombosis in pronated animals with ARDS.Intensive care medicine experimental · 2025Article
- Effect of prone position on ventilation-perfusion matching in patients with moderate to severe ARDS with different clinical phenotypes.Respiratory research · 2025Observational
- Quantitative Computed Tomography and Response to Pronation in COVID-19 ARDS.Respiratory care · 2024Observational
- Article
- Prone Positioning for Patients With COVID-19-Induced Acute Hypoxemic Respiratory Failure: Flipping the Script.Respiratory care · 2023Review
- Extended prone positioning for intubated ARDS: a review.Critical care (London, England) · 2023Review
- Exogenous surfactant reduces inflammation and redox imbalance in rats under prone or supine mechanical ventilation.Experimental biology and medicine (Maywood, N.J.) · 2023Article
- Lung ultrasound to evaluate aeration changes in response to recruitment maneuver and prone positioning in intubated patients with COVID-19 pneumonia: preliminary study.The ultrasound journal · 2023Article
- New and personalized ventilatory strategies in patients with COVID-19.Frontiers in medicine · 2023Review
- Pulmonary air leak in COVID-19: time to learn from our mistakes.Intensive care medicine · 2022Article
- Article
- COVID-19-Related ARDS: Key Mechanistic Features and Treatments.Journal of clinical medicine · 2022Review
- Effect of prone positioning on end-expiratory lung volume, strain and oxygenation change over time in COVID-19 acute respiratory distress syndrome: A prospective physiological study.Frontiers in medicine · 2022Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProne positioning improves survival in moderate-to-severe acute respiratory distress syndrome (ARDS) unrelated to the novel coronavirus disease (COVID-19). This benefit is probably mediated by a decrease in alveolar collapse and hyperinflation and a more homogeneous distribution of lung aeration, with fewer harms from mechanical ventilation. In this preliminary physiological study we aimed to verify whether prone positioning causes analogue changes in lung aeration in COVID-19. A positive result would support prone positioning even in this other population.
methodsFifteen mechanically-ventilated patients with COVID-19 underwent a lung computed tomography in the supine and prone position with a constant positive end-expiratory pressure (PEEP) within three days of endotracheal intubation. Using quantitative analysis, we measured the volume of the non-aerated, poorly-aerated, well-aerated, and over-aerated compartments and the gas-to-tissue ratio of the ten vertical levels of the lung. In addition, we expressed the heterogeneity of lung aeration with the standardized median absolute deviation of the ten vertical gas-to-tissue ratios, with lower values indicating less heterogeneity.
resultsBy the time of the study, PEEP was 12 (10-14) cmH
conclusionsIn fifteen patients with COVID-19, prone positioning decreased alveolar collapse, hyperinflation, and homogenized lung aeration. A similar response has been observed in other ARDS, where prone positioning improves outcome. Therefore, our data provide a pathophysiological rationale to support prone positioning even in COVID-19.
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