Prone position versus usual care in hypoxemic COVID-19 patients in medical wards: a randomised controlled trial

Article Respiratory System

High-flow nasal oxygen versus conventional oxygen therapy in patients with COVID-19 pneumonia and mild hypoxaemia: a randomised controlled trial

Claudia Crimi et al.

Summary: Among patients with COVID-19 pneumonia and mild hypoxaemia, the use of HFNO did not significantly reduce the likelihood of escalation of respiratory support.

THORAX (2023)

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Article Medicine, General & Internal

Effect of Noninvasive Respiratory Strategies on Intubation or Mortality Among Patients With Acute Hypoxemic Respiratory Failure and COVID-19 The RECOVERY-RS Randomized Clinical Trial

Gavin D. Perkins et al.

Summary: Among patients with acute hypoxemic respiratory failure due to COVID-19, an initial strategy of CPAP significantly reduced the risk of tracheal intubation or mortality compared with conventional oxygen therapy, but there was no significant difference between an initial strategy of HFNO compared with conventional oxygen therapy. The study may have been underpowered for the comparison of HFNO vs conventional oxygen therapy, and early study termination and crossover among the groups should be considered when interpreting the findings.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2022)

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Article Respiratory System

Awake prone positioning and oxygen therapy in patients with COVID-19: the APRONOX study

Orlando R. Perez-Nieto et al.

Summary: The study suggests that awake prone positioning can reduce the risk of intubation and mortality in hospitalized patients with COVID-19. Factors associated with intubation in awake prone patients include increasing age, baseline PaO2/FiO2 ratio, and management with a nonrebreather mask.

EUROPEAN RESPIRATORY JOURNAL (2022)

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Article Medicine, General & Internal

Effect of Awake Prone Positioning on Endotracheal Intubation in Patients With COVID-19 and Acute Respiratory Failure A Randomized Clinical Trial

Waleed Alhazzani et al.

Summary: A study on nonintubated adult patients with acute hypoxemia and COVID-19 found that prone positioning did not significantly reduce the rate of endotracheal intubation within 30 days compared to usual care without prone positioning.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2022)

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Article Medicine, General & Internal

Prone positioning of patients with moderate hypoxaemia due to covid-19: multicentre pragmatic randomised trial (COVID-PRONE)

Michael Fralick et al.

Summary: Among non-critically ill patients with Covid-19 admitted to the hospital, prone positioning did not improve outcomes and the potential benefits or harms cannot be definitively ruled out. Poor adherence to prone positioning highlights the need for strategies to improve compliance in future trials.

BMJ-BRITISH MEDICAL JOURNAL (2022)

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Article Medicine, General & Internal

Assessment of Awake Prone Positioning in Hospitalized Adults With COVID-19 A Nonrandomized Controlled Trial

Edward Tang Qian et al.

Summary: Awake prone positioning does not provide clinical benefit for COVID-19 patients with hypoxemia who have not received mechanical ventilation. There is even evidence suggesting potential harm from the awake prone positioning intervention.

JAMA INTERNAL MEDICINE (2022)

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Review Critical Care Medicine

Awake prone positioning for non-intubated patients with COVID-19-related acute hypoxaemic respiratory failure: a systematic review and meta-analysis

Jie Li et al.

Summary: Awake prone positioning can reduce the need for intubation in patients with COVID-19-related acute hypoxaemic respiratory failure, particularly among those requiring advanced respiratory support or treated in the ICU.

LANCET RESPIRATORY MEDICINE (2022)

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Article Medicine, General & Internal

Does awake prone positioning prevent the use of mechanical respiratory support or death in COVID-19 patients on standard oxygen therapy hospitalised in general wards? A multicentre randomised controlled trial: the PROVID-19 protocol

Mai-Anh Nay et al.

Summary: This study aims to compare the effectiveness of awake prone positioning with standard care in hypoxaemic COVID-19 patients. Participants are randomly assigned to the awake prone position plus usual care group or the usual care alone group. The primary outcome is the rate of treatment failure at 28 days, defined as the need for non-invasive ventilation (at two pressure levels) or intubation or death.

BMJ OPEN (2022)

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Article Critical Care Medicine

Factors for success of awake prone positioning in patients with COVID-19-induced acute hypoxemic respiratory failure: analysis of a randomized controlled trial

Miguel Ibarra-Estrada et al.

Summary: Awake prone positioning (APP) can reduce intubation rate and improve treatment success in COVID-19 patients. Longer duration of APP, increase in ROX index after APP, and decrease in lung ultrasound score are significantly associated with treatment success.

CRITICAL CARE (2022)

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Article Medicine, General & Internal

Prone position in wards for spontaneous breathing Covid-19 patients: a retrospective study

Johan Wormser et al.

Summary: The study found that prone position therapy in ward hypoxemic patients with Covid-19 can improve oxygenation and is well tolerated, although some patients may not respond well. The effectiveness of this technique varies depending on individual patient factors.

IRISH JOURNAL OF MEDICAL SCIENCE (2021)

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Article Medicine, General & Internal

Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid-19 admitted to hospital: RAPID randomised clinical trial

Michelle Sholzberg et al.

Summary: This study aimed to evaluate the effects of therapeutic heparin compared with prophylactic heparin among moderately ill patients with covid-19 admitted to hospital wards. The results of the study may help guide the treatment options for similar patients in the future.

BMJ-BRITISH MEDICAL JOURNAL (2021)

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Letter Critical Care Medicine

Effect of Prone Positioning on the Respiratory Support of Nonintubated Patients With COVID-19 and Acute Hypoxemic Respiratory Failure A Retrospective Matching Cohort Study

Eloi Prud'homme et al.

CHEST (2021)

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Article Critical Care Medicine

Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: a randomised, controlled, multinational, open-label meta-trial

Stephan Ehrmann et al.

Summary: Awake prone positioning in patients with hypoxaemic respiratory failure due to COVID-19 reduces the incidence of treatment failure and the need for intubation without any signal of harm.

LANCET RESPIRATORY MEDICINE (2021)

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Article Critical Care Medicine

Efficacy and safety of baricitinib for the treatment of hospitalised adults with COVID-19 (COV-BARRIER) : a randomised, double-blind, parallel-group, placebo- controlled phase 3 trial

Vincent C. Marconi et al.

Summary: Although there was no significant reduction in the frequency of disease progression overall, treatment with baricitinib in addition to standard of care (including dexamethasone) had a similar safety profile to that of standard care alone, and was associated with reduced mortality in hospitalised adults with COVID-19.

LANCET RESPIRATORY MEDICINE (2021)

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Article Medicine, General & Internal

Effect of High-Flow Oxygen Therapy vs Conventional Oxygen Therapy on Invasive Mechanical Ventilation and Clinical Recovery in Patients With Severe COVID-19 A Randomized Clinical Trial

Gustavo A. Ospina-Tascon et al.

Summary: In a randomized clinical trial conducted in Colombia, it was found that high-flow oxygen therapy through a nasal cannula significantly reduced the need for mechanical ventilation support and shortened time to clinical recovery in patients with severe COVID-19 compared to conventional oxygen therapy.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2021)

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Article Respiratory System

Awake Prone Positioning Strategy for Nonintubated Hypoxic Patients with COVID-19 A Pilot Trial with Embedded Implementation Evaluation

Stephanie Parks Taylor et al.

Summary: This study aimed to identify contextual factors relevant to the conduct of a definitive clinical trial evaluating a prone positioning strategy for nonintubated hypoxic patients with COVID-19. The results showed that patients in the prone positioning group had better oxygenation effects. However, existing barriers include low adherence to prone positioning, large differences between physician-recommended and patient-tolerated prone durations, and diffusion of prone positioning into usual care.

ANNALS OF THE AMERICAN THORACIC SOCIETY (2021)

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Article Critical Care Medicine

Awake prone positioning in patients with hypoxemic respiratory failure due to COVID-19: the PROFLO multicenter randomized clinical trial

Jacob Rosen et al.

Summary: The trial showed that the implemented protocol for awake prone positioning increased the duration of prone positioning, but did not reduce the intubation rate in patients with hypoxemic respiratory failure due to COVID-19 compared to standard care.

CRITICAL CARE (2021)

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Article Respiratory System

Self-proning in COVID-19 patients on low-flow oxygen therapy: a cluster randomised controlled trial

Aileen Kharat et al.

Summary: The study aimed to investigate the effect of self-prone positioning in reducing oxygen needs in patients with COVID-19 pneumonia. Results showed that self-prone positioning led to a clinically meaningful reduction in oxygen flow, but did not reach statistical significance.

ERJ OPEN RESEARCH (2021)

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Letter Medicine, General & Internal