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Postural PositioningWiki

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There is one clinical trial.

Clinical Trials


1 UPright Incline Positioning in COVID-19 Patients for Oxygen SATuration Improvement With Hypoxemic Respiratory Failure (UPSAT)

COVID-19 is a respiratory illness caused by SARS-CoV-2 with a range of symptoms from mild, self-limiting respiratory tract infections to severe progressive pneumonia, multiorgan dysfunction and death. A portion of individuals with COVID-19 experience life-threatening hypoxia requiring supplemental oxygen and mechanical ventilation. Management of hypoxia in this population is complicated by contraindication of non-invasive ventilation and limitations in access to mechanical ventilation and critical care staff given the clinical burden of disease. Positional therapy is readily deployable and may ultimately be used to treat COVID-19 related respiratory failure in resources limited settings; and, it has been demonstrated to improve oxygenation and is easy to implement in the clinical setting. The overall goal of this randomized controlled trial is to establish the feasibility of performing a randomized trial using a simple, minimally invasive positional therapy approach to improve hypoxia and reduce progression to mechanical ventilation. The objectives are to examine the effectiveness and feasibility of maintaining an inclined position in patients with confirmed or suspected COVID-19 associated hypoxemic respiratory failure. The investigators hypothesize that (1) oxyhemoglobin saturation will improve with therapy, (2) participants will tolerate and adhere to the intervention, and that (3) participants who adhere to positional therapy will have reduced rates of mechanical ventilation at 72 hours. If successful, this feasibility trial will demonstrate that a simple, readily deployed nocturnal postural maneuver is well tolerated and reverses underlying defects in ventilation and oxygenation due to COVID-19. It will also inform the design of a pivotal Phase III trial with estimates of sample sizes for clinically relevant outcomes.

NCT04344561 COVID Hypoxic Respiratory Failure Other: Postural Positioning
MeSH:Respiratory Insufficiency

Primary Outcomes

Description: Number of participants needing mechanical ventilation over total number of participants per arm.

Measure: Incidence of Mechanical Ventilation

Time: 72 hours

Description: Percentage of time participants stay in the assigned position will be used to determine adherence.

Measure: Percentage of time in the assigned position

Time: 72 hours

Secondary Outcomes

Description: Number of participants with supplemental oxygen requirements.

Measure: Number of participants with supplemental oxygen requirements

Time: 72 hours

Description: Mean oxyhemoglobin saturation (percentage) measured over a 24-hour period.

Measure: Change in mean oxyhemoglobin saturation

Time: At 24, 48 and 72 hours

Description: Mean oxyhemoglobin saturation (percentage) measured over an 8-hour period (between 10pm and 6am).

Measure: Change in Nocturnal Oxyhemoglobin saturation

Time: Measured between 10pm and 6am daily, up to 72 hours

Description: Heart Rate (beats per minute) on Routine Vital Sign Assessment.

Measure: Change in Heart Rate

Time: At 10, 24, 48 and 72 hours

Description: Respiratory Rate (cycles per minute) on Routine Vital Sign Assessment.

Measure: Change in Respiratory Rate

Time: At 10, 24, 48 and 72 hours

Other Outcomes

Description: Mean oxyhemoglobin saturation (percentage) during final 7 minutes in a position.

Measure: Acute change in oxyhemoglobin saturation

Time: During the final 7 minutes at each position, up to 72 hours


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