Awaken Prone Positioning Ventinlation in COVID-19 Patients

Southeast University, China409 enrolled

Overview

Awaken prone positioning (APP) ventilation has been widely accepted as a standard regimen in the management of COVID-19 patients. Physiological studies have proved ventilation/perfusion improvement during APP in COVID-19, which was associated improved oxygenation. However, the optimal duration for APP was not yet demonstrated. In this study, we aimed at the prolonged APP to see whether this could improve patients outcomes.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

409

Conditions

COVID-19

Interventions

Awaken prone positioning ventilationPROCEDURE

patients were mandated to keep a prone position for at least 12 hours.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aged \> 18-yr to 85-yr * Severe COVID-19 pneumonia (with typical radiographic alternations) and non-intubated patients. * SpO2 \<= 93% with ambient air at rest. * PaO2/FiO2 \<= 300 mmHg Exclusion Criteria: * Definite intolerance to APP (e.g. pregnancy, extremity deformity, recent fracture, open thoracic or abdominal surgery, pace-maker implant in recent 48-hr, spine stability, pelvis or facial fractures, predicted difficult airway) * morbidity obesity, BMI \> 40 * consciousness disorder (GCS \< 13), delirium dementia * hemodynamic instability (with norepinephrine \>20 ug/min ) * NYHA Grade III or IV * Severe hemoptysis * long term home oxygenation of CPAP * Refuse invasive mechanical ventilation (DNI DNR)

Locations (1)

Southeast University

Nanjing, Jiangsu, China

Outcomes

Primary Outcomes

28-day intubation rate

whether the patients' were intubated

Time frame: follow-up till 28-day

Secondary Outcomes

APP duration/days

hours of APP per day

Time frame: follow-up till APP ended, daily duration of APP also recoreded, up to 7 days

Application of HFNC NIV vasopressor CRRT ECMO sedation, or complication

Whether to apply these treatments，any complications occur,days free from respiratory support and days free from invasive mechanical ventilation at 28 day

Time frame: follow-up till 28-day

mortality (ICU hospital) length of ICU (hospital) stay

mortality AND mortality and length of stay at 28 day

Time frame: follow-up during the ICU/hospital stay, up to 28 days

Data from ClinicalTrials.gov

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