Covid 19 Research using Clinical Trials (Home Page)
1: Prone positioningWiki
Developed by Shray Alag
Clinical Trial MeSH HPO Drug Gene SNP Protein Mutation
Correlated Drug Terms (2)
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drug821 | Tele-medicine platform Wiki | 1.00 |
drug12 | 2: No instruction regarding positioning Wiki | 1.00 |
Correlated MeSH Terms (9)
Correlated HPO Terms (0)
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There is one clinical trial.
Clinical Trials
The COVID epidemics is responsible for a huge number of death following COVID acute
respiratory failure. First instance treatment includes oxygenotherapy up to 15L/min in
spontaneous ventilation. However COVID infection can ultimately lead to an acute respiratory
distress syndrome (ARDS) requiring mechanical ventilation in the intensive care unit (ICU).
Guidelines on ARDS management are based on small ventilation volume (6 mL/kg), a pulmonary
end expiratory pressure (PEEP) chosen to get the best pulmonary compliance, a plateau
pressure lower than 30 cm of water and daily prone positioning when PaO2/FiO2 ratio is lower
than 150. In ventilated ARDS patients, prone positioning has shown survival improvement.
Though they applied this optimized management of ARDS patients, Chinese intensivists have
recently reported mortality rate higher than 50% in ARDS COVID patients requiring intubation
and mechanical ventilation. Before being intubated and admitted to ICU, COVID patients
require increasing rate of oxygen delivery. From the start of the epidemics, we have observed
that an oxygenotherapy rate higher than 3L/min at the initial phase of the disease was
associated with a high risk of severe acute respiratory distress (30%)
The investigators hypothesize that prone positioning in patients in spontaneous ventilation
(not tubed) from the stage of oxygenotherapy higher than 3L/min (to get an SpO2 of 95% or
higher) would prevent respiratory worsening and the need for intubation. Prone positioning is
easy to apply in patients in spontaneous ventilation since they can change position by
themselves.
NCT04366856 COVID ARDS Behavioral: 1: Prone positioning Behavioral: 2: No instruction regarding positioning
Primary Outcomes
Measure: Proportion of patients who meet one or both following criteria: need for intubation (for mechanical ventilation), occurrence of death during hospital stay. Time: At day28
Secondary Outcomes
Measure: Proportion of patients admitted to ICU (for patients included out of ICU) Time: At day28
Measure: Days alive and free from non invasive ventilation (NIV) or high flow nasal canula oxygen delivery (HFNC) (for those neither under NIV or HFNC at the time of study inclusion) Time: At day28
Measure: Days alive and out of ICU Time: At day28
Measure: Days alive and out of hospital Time: At day28
Measure: Maximum oxygenotherapy rate during hospital stay [Time Frame: At day28] Time: At day28
No related HPO nodes (Using clinical trials)