ArticleAnnals of intensive care2025
Oxygenation improvement and duration of prone positioning are associated with ICU mortality in mechanically ventilated COVID-19 patients.
Article in Annals of intensive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Definition and prognostic value of response to prone positioning in ARDS: a systematic review and meta-analysis.Critical care (London, England) · 2026Pooled it
- Effectiveness and safety of prolonged prone positioning in adult patients with acute respiratory distress syndrome (ARDS): a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Obesity: biomechanical implications for mechanical ventilation.Critical care (London, England) · 2026Review
- Reply to "PROVENT-C19 repeated prone positioning analysis": not everything that differs is inconsistent.Journal of anesthesia, analgesia and critical care · 2026Article
- Comment on PROVENT-C19 repeated prone positioning analysis.Journal of anesthesia, analgesia and critical care · 2026Article
- Association between PaO2/FiO2 trajectories and survival outcomes in patients with sepsis-associated acute respiratory failure under invasive mechanical ventilation: a retrospective cohort analysis based on MIMIC-IV database.BMC pulmonary medicine · 2026Article
- Dead space in critical care: a practical approach with clinical scenarios.Journal of anesthesia, analgesia and critical care · 2026Review
- 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
- Ventilator-Induced Lung Injury: The Unseen Challenge in Acute Respiratory Distress Syndrome Management.Journal of clinical medicine · 2025Review
- Effect of BALF-based mNGS on clinical outcomes of immunocompromised subjects with opportunistic pulmonary infections: a multicenter propensity score-matched study.Frontiers in cellular and infection microbiology · 2025Article
Corrections and comments
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Authors and funding
24 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProne position has been diffusely applied in mechanically ventilated COVID-19 patients. Our aim is ascertaining the association between the physiologic response and the length of the first cycle of prone position and intensive care unit (ICU) mortality.
methodsInternational registry including COVID-19 adult patients who underwent prone positioning. We measured the difference for arterial partial pressure of oxygen to inspired fraction of oxygen ratio (PaO2/FiO2), ventilatory ratio, and respiratory system compliance (Crs) between baseline supine position and at either the end of the first cycle of prone position (Delta-PP) or re-supination (Delta-PostPP).
resultsWe enrolled 1816 patients from 53 centers. Delta-PP and Delta-PostPP for PaO2/FiO2 were both associated with ICU mortality [OR (95% CI) 0.48 (0.38, 0.59), and OR (95% CI) 0.60 (0.52, 0.68), respectively]. Ventilatory ratio had a non-linear relationship with ICU mortality for Delta-PP (p = 0.022) and Delta-PostPP (p = 0.004). Delta-PP, while not Delta-PostPP, for Crs was associated with ICU mortality [OR (95% CI) 0.80 (0.65, 0.98)]. The length of the first cycle of prone position showed an inverse relationship with ICU mortality [OR (95% CI) 0.82 (0.73, 0.91)]. At the multivariable analysis, the duration of the first cycle of prone position, Delta-PP and Delta-PostPP for PaO2/FiO2, and Delta-PostPP for ventilatory ratio were independently associated with ICU mortality.
conclusionIn COVID-19 patients with acute respiratory failure receiving invasive mechanical ventilation and prone positioning, the physiological response to prone position is associated with ICU mortality. Prolonging the duration of the first cycle of prone position is associated with improved survival.
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