ArticleJournal of intensive care2025
The effects of prolonged prone positioning on response and prognosis in patients with acute respiratory distress syndrome: a retrospective cohort study.
Article in Journal of intensive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Awake prone positioning reduces mortality, intubation, and hospital stay in acute hypoxemic respiratory failure: a systematic review and meta-analysis of 6,164 patients.BMC anesthesiology · 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
- Effects of prone versus supine position during enteral nutrition on clinical outcomes and complications in mechanically ventilated patients: a systematic review and meta-analysis.Frontiers in nutrition · 2025Pooled it
- Shoulder Injuries Secondary to Proning: Sequelae of Long COVID Syndrome: A Case Report.Journal of orthopaedic case reports · 2026Article
- Early prone positioning after tetralogy of fallot repair in children: a retrospective cohort study of oxygenation, safety, and short-term outcomes.Frontiers in cardiovascular medicine · 2026Article
- A gradient boosting machine model for predicting prognosis in patients with acute respiratory distress syndrome.American journal of translational research · 2026Article
- Association between prognostic nutritional index and 28-day mortality in patients with sepsis-associated acute respiratory distress syndrome.Frontiers in nutrition · 2026Article
- Different Duration of Prone Positioning Treatment for Patients with Acute Respiratory Distress Syndrome in Intensive Care Unit Patients: A Prospective Randomized Clinical Study.Journal of clinical medicine · 2025Article
- Optimizing Airway Function Through Craniofacial and Cervical Manipulations and Emergency-Anesthesia Maneuvers: Applications in Airway Function Enhancement, Pneumonia, and Asthma-Narrative Review.Journal of clinical medicine · 2025Review
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Authors and funding
11 authors.
Funding
Abstract
backgroundProne positioning improves outcomes in patients with acute respiratory distress syndrome (ARDS), but the optimal duration in critical care settings remains uncertain. This study aims to evaluate the investigates the impact of prone ventilation duration on clinical outcomes.
methodsThis retrospective study was conducted on ARDS patients admitted to the intensive care unit (ICU), Nanfang hospital of Southern Medical University, who received prone positioning. Patients were categorized into two groups: the prolonged prone positioning (PPP) (≥ 16 h) group and the standard prone positioning (SPP) (< 16 h) group. Propensity score matching (PSM) was employed to balance baseline characteristics. Cox proportional hazards, regression models were utilized to evaluate the association between the prone duration and clinical outcomes. Kaplan-Meier survival curves were generated to compare 28-day mortality, with log-rank tests analyzing differences. Restricted cubic spline (RCS) were applied to investigate the time-response between prone duration, PaCO₂, PaO₂, positive end-expiratory pressure, response rate, and 28-day mortality. In addition, the incidence of prone position-related complications was assessed in both groups.
resultsA total of 234 patients with ARDS were included, with an overall 28-day mortality of 49.1% (115/234). After PSM, 81 matched pairs were compared. The PPP group had lower 28-day mortality (46.9% vs. 53.1%; hazard ratios (HR): 0.53; 95% CI 0.32-0.85; P = 0.033) and improved prone positioning response rate [70.5% vs. 60.5%; odds ratio (OR): 1.46; 95% CI 1.23-1.89; P = 0.025]. RCS analysis suggested a reduction in mortality with prone durations ≥ 16 h, and longer durations correlated with better prone response. However, no significant association was found between PPP and reduced ICU or hospital length of stay. RCS analysis indicated a gradual decrease in 28-day mortality with increasing duration of prone positioning, and longer duration were associated with a higher likelihood of a prone response. There were no significant differences in prone ventilation-related complications between the two groups.
conclusionsPPP (≥ 16 h) is associated with reduced 28-day mortality and improved response rates in ICU patients with ARDS, without increasing complication risks. Prospective studies are needed to further validate these results.
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