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General Critical Care

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Efficacy of awake prone positioning in patients with covid-19 related hypoxemic respiratory failure: systematic review and meta-analysis of randomized trials


17 trials (2931 patients) were included in the systematic review

• Awake prone positioning was found to reduce the risk of endotracheal intubation compared with usual care

• This translates to 55 fewer intubations per 1000 patients

• Awake prone positioning did not significantly affect secondary outcomes, including mortality, ventilator-free days, ICU length of stay, hospital length of stay, and escalation of oxygen modality

• Adverse events related to awake prone positioning were uncommon.


The reduction in intubation was driven mainly by trials that achieved longer duration of prone positioning (median ≥5 hours per day), targeted patients with more severe hypoxaemia (median peripheral oxygen saturation to fraction of inspired oxygen ratio <150), and focused on patients requiring high flow oxygen or non-invasive ventilation.



https://www.bmj.com/content/379/bmj-2022-071966#:~:text=Principal%20findings,failure%20due%20to%20covid%2D19.


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