Evidence map›Paper›PMID 39088076›Full record

Trial reportIntensive care medicine2024

Prolonged vs shorter awake prone positioning for COVID-19 patients with acute respiratory failure: a multicenter, randomised controlled trial.

Ling Liu, Qin Sun, Hongsheng Zhao, Weili Liu, Xuehua Pu, Jibin Han, Jiangquan Yu, Jun Jin, Yali Chao, Sicong Wang and 11 more

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Intensive care medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Prone positioning in ARDS.Intensive care medicine · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Ling Liu *Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China.
Qin Sun *Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China.
Hongsheng Zhao *Department of Intensive Care Unit, Affiliated Hospital of Nantong University, Nantong, China.
Weili Liu *Department of Intensive Care, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
Xuehua Pu *Department of Intensive Care Unit, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, Jiangsu, China.
Jibin Han *Department of Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Jiangquan YuDepartment of Critical Care Medicine, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China.
Jun JinDepartment of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Yali ChaoJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China.
Sicong WangDepartment of Intensive Care Unit, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Yu LiuDepartment of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Bin WuDepartment of Intensive Care Unit, Third Hospital of Xiamen, Xiamen, Fujian, China.
Ying ZhuDepartment of Critical Care Medicine, Hangzhou First People's Hospital, Hangzhou, 310006, China.
Yang LiJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China.
Wei ChangJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China.
Tao Chen *Center for Health Economics, University of York, York, UK.
Jianfeng Xie *Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China.
Yi Yang *Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China.
Haibo Qiu *Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China. haiboq2000@163.com.ORCID 0000-0001-8589-4717
Arthur Slutsky *Interdepartmental Division of Critical Care Medicine, Departments of Medicine, Surgery, and Biomedical Engineering, University of Toronto, Toronto, Canada.
Chi-ARDS Net (Chinese ARDS Research Network)

Funding

Key Laboratory of Jiangsu Province for Chemical Pollution Control and Resources Reuse ZDXYS202205National Key Research and Development Program of China 2022YFC2504405National Natural Science Foundation of China 81930058National Natural Science Foundation of China 82270083National Natural Science Foundation of China 82341032Project of High-level Teachers in Beijing Municipal Universities in the Period of 13th Five-year Plan LGY2022025
6 · The paper itself

Abstract

purposeAwake prone positioning has been reported to reduce endotracheal intubation in patients with coronavirus disease 2019 (COVID-19)-related acute hypoxemic respiratory failure (AHRF). However, it is still unclear whether using the awake prone positioning for longer periods can further improve outcomes.

methodsIn this randomized, open-label clinical trial conducted at 12 hospitals in China, non-intubated patients with COVID-19-related AHRF were randomly assigned to prolonged awake prone positioning (target > 12 h daily for 7 days) or standard care with a shorter period of awake prone positioning. The primary outcome was endotracheal intubation within 28 days after randomization. The key secondary outcomes included mortality and adverse events.

resultsIn total, 409 patients were enrolled and randomly assigned to prolonged awake prone positioning (n = 205) or standard care (n = 204). In the first 7 days after randomization, the median duration of prone positioning was 12 h/d (interquartile range [IQR] 12-14 h/d) in the prolonged awake prone positioning group vs. 5 h/d (IQR 2-8 h/d) in the standard care group. In the intention-to-treat analysis, intubation occurred in 35 (17%) patients assigned to prolonged awake prone positioning and in 56 (27%) patients assigned to standard care (relative risk 0.62 [95% confidence interval (CI) 0.42-0.9]). The hazard ratio (HR) for intubation was 0.56 (0.37-0.86), and for mortality was 0.63 (0.42-0.96) for prolonged awake prone positioning versus standard care, within 28 days. The incidence of pre-specified adverse events was low and similar in both groups.

conclusionProlonged awake prone positioning of patients with COVID-19-related AHRF reduces the intubation rate without significant harm. These results support prolonged awake prone positioning of patients with COVID-19-related AHRF.

Indexed as

COVID-19Intubation, IntratrachealPatient PositioningRespiratory InsufficiencyAgedChinaFemaleHumansMaleMiddle AgedProne PositionSARS-CoV-2Time FactorsWakefulnessCOVID-19-related acute respiratory failureIntubationMortalityProlonged awake prone positioning

Identifiers

PMID39088076
PMCPMC11306533

What Socratic holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.