Impact of exposure time in awake prone positioning on clinical outcomes of patients with COVID-19-related acute respiratory failure treated with high-flow nasal oxygen: a multicenter cohort study

Simple item page
dc.contributor.authorEsperatti, Mariano
dc.contributor.authorBusico, Marina
dc.contributor.authorFuentes, Nora Angélica
dc.contributor.authorGallardo, Adrián
dc.contributor.authorOsatnik, Javier
dc.contributor.authorVitali, Alejandra
dc.contributor.authorWasinger, Elizabeth Gisele
dc.contributor.authorOlmos, Matías
dc.contributor.authorQuintana, Jorgelina
dc.contributor.authorBruhn, Alejandro
dc.date.accessioned2022-03-14T15:41:09Z
dc.date.available2022-03-14T15:41:09Z
dc.date.issued2022
dc.date.updated2022-01-09T01:03:11Z
dc.description.abstractBackground: In patients with COVID-19-related acute respiratory failure (ARF), awake prone positioning (AW-PP) reduces the need for intubation in patients treated with high-flow nasal oxygen (HFNO). However, the effects of different exposure times on clinical outcomes remain unclear. We evaluated the effect of AW-PP on the risk of endotracheal intubation and in-hospital mortality in patients with COVID-19-related ARF treated with HFNO and analyzed the effects of different exposure times to AW-PP. Methods: this multicenter prospective cohort study in six ICUs of 6 centers in Argentine consecutively included patients > 18 years of age with confirmed COVID-19-related ARF requiring HFNO from June 2020 to January 2021. In the primary analysis, the main exposure was awake prone positioning for at least 6 h/day, compared to non-prone positioning (NON-PP). In the sensitivity analysis, exposure was based on the number of hours receiving AW-PP. Inverse probability weighting–propensity score (IPW-PS) was used to adjust the conditional probability of treatment assignment. The primary outcome was endotracheal intubation (ETI); and the secondary outcome was hospital mortality. Results : during the study period, 580 patients were screened and 335 were included; 187 (56%) tolerated AW-PP for [median (p25–75)] 12 (9–16) h/day and 148 (44%) served as controls. The IPW–propensity analysis showed standardized differences < 0.1 in all the variables assessed. After adjusting for other confounders, the OR (95% CI) for ETI in the AW-PP group was 0.36 (0.2–0.7), with a progressive reduction in OR as the exposure to AW-PP increased. The adjusted OR (95% CI) for hospital mortality in the AW-PP group ≥ 6 h/day was 0.47 (0.19–1.31). The exposure to prone positioning ≥ 8 h/d resulted in a further reduction in OR [0.37 (0.17–0.8)]. Conclusion : In the study population, AW-PP for ≥ 6 h/day reduced the risk of endotracheal intubation, and exposure ≥ 8 h/d reduced the risk of hospital mortality.
dc.format.extent9 páginas
dc.fuente.origenAutoarchivo
dc.identifier.citationCritical Care, 2022, Jan 07, 26:16
dc.identifier.urihttps://doi.org/10.1186/s13054-021-03881-2
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/63350
dc.information.autorucEscuela de medicina ; Bruhn, Alejandro ; 0000-0001-8034-1937 ; 741
dc.issue.numeroNo. 16
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final10
dc.pagina.inicio1
dc.relation.isformatofCritical Care, vol. 26, no. 16 (Jan., 2022), 10 páginas
dc.revistaCritical Care
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.subjectAcute respiratory failurees_ES
dc.subjectAwakees_ES
dc.subjectCOVID-19es_ES
dc.subjectEndotracheal intubationes_ES
dc.subjectMortalityes_ES
dc.subjectProne positiones_ES
dc.subject.ddc362.2068
dc.subject.deweyCiencias socialeses_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleImpact of exposure time in awake prone positioning on clinical outcomes of patients with COVID-19-related acute respiratory failure treated with high-flow nasal oxygen: a multicenter cohort studyes_ES
dc.typeartículo
dc.volumenVol. 26
sipa.codpersvinculados741
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
13054_2021_Article_3881.pdf
Size:
917.61 KB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
0 B
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Artículos de revistas