ArticleIntensive care medicine2024
Early physiologic changes after awake prone positioning predict clinical outcomes in patients with acute hypoxemic respiratory failure.
Article 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 7 papers.
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Who cites it
7 citing papers in PubMed.
- The Acute Respiratory Distress Syndrome (ARDS): epidemiology, etiology, molecular mechanisms, diagnosis and therapeutic strategies.Molecular biomedicine · 2026Review
- Update on acute respiratory failure.Intensive care medicine · 2026Article
- Awake patients' experiences and coping needs during awake prone positioning in general wards: a patient-perspective qualitative study.Frontiers in medicine · 2026Article
- Refining the use of neuromuscular blockade in ARDS: lessons from a post hoc Markov model re-analysis of the ACURASYS trial.Intensive care medicine · 2025Article
- A predictive model for early intubation in patients with COVID-19-induced acute hypoxemic respiratory failure under awake prone position.Annals of intensive care · 2025Article
- A nomogram for predicting intra-operative conversion to endotracheal intubation during non-intubated spontaneous ventilation anesthesia in pulmonary resection: development of a risk prediction model in hypoxic and high-risk patients.Frontiers in medicine · 2025Article
- Association of the ROX index with mortality in sepsis patients: a retrospective study.Frontiers in medicine · 2025Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe optimal physiologic parameters to monitor after a session of awake prone positioning in patients with acute respiratory failure are not well understood. This study aimed to identify which early physiologic changes after the first session of awake prone positioning are linked to the need for invasive mechanical ventilation or death in patients with acute respiratory failure.
methodsWe performed a secondary analysis of a prospective cohort study of adult patients with acute respiratory failure related to coronavirus disease 2019 (COVID-19) treated with awake prone positioning. We assessed the association between relative changes in physiological variables (oxygenation, respiratory rate, pCO
results244 patients [70 female (29%), mean age 60 (standard deviation [SD] 13) years] were included. Seventy-one (29%) patients experienced awake prone positioning failure. ROX index was the main physiologic predictor. Patients with treatment failure had lower mean [SD] ROX index at baseline [5 (1.4) versus 6.6 (2.2), p < 0.0001] and within 6 h of prone positioning [5.6 (1.7) versus 8.7 (2.8), p < 0.0001]. After adjusting for baseline characteristics and severity, a relative increase of the ROX index compared to baseline was associated with lower odds of failure [odds ratio (OR) 0.37; 95% confidence interval (CI) 0.25-0.54 every 25% increase].
conclusionRelative changes in the ROX index within 6 h of the first awake prone positioning session along with other known predictive factors are associated with intubation and mortality at day 7.
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