Name (Synonyms) | Correlation | |
---|---|---|
drug2333 | Standard of care. Wiki | 0.71 |
drug2376 | Supine Positioning Wiki | 0.71 |
There are 2 clinical trials
Prone positioning (PP) is an effective first-line intervention to treat moderate-severe acute respiratory distress syndrome (ARDS) patients receiving invasive mechanical ventilation, as it improves gas exchanges and lowers mortality.The use of PP in awake self-ventilating patients with (e.g. COVID-19 induced) ARDS could improve gas exchange and reduce the need for invasive mechanical ventilation, but has not been studied outside of case series.The investigators will conduct a randomized controlled study of patients with COVID-19 induced respiratory failure to determine if prone positioning reduces the need for mechanical ventilation compared to standard management.
Description: A measure of effect of awake prone positioning in reducing requirement for invasive mechanical ventilation.
Measure: The effect of prone positioning on requirement for invasive mechanical ventilation in patients with COVID 19 induced respiratory failure. Time: Up to 28 days post randomisationDescription: Total time spent in prone and supine position as recorded by nurse
Measure: Length of time tolerating prone positioning Time: Daily during intervention up to 28 days post randomisationDescription: Measure of change in oxygenation before intervention
Measure: PaO2/FiO2 measured before prone positioning Time: Immediately before interventionDescription: Measure of change in oxygenation following intervention
Measure: PaO2/FiO2 ratio after 1 hours of prone positioning Time: During interventionDescription: Measure of change in oxygenation using pulse oximetry before intervention where ABG not available
Measure: SpO2/FiO2 ratio measured before prone positioning Time: Immediately before interventionDescription: Measure of change in oxygenation before intervention where ABG not available
Measure: SpO2/FiO2 ratio after 1 hours of prone positioning Time: During InterventionDescription: Escalation of ventilatory support
Measure: Number requiring increase in ventilatory assistance (CPAP+BIPAP+IMV etc) Time: Up to 28 days post randomisationDescription: Measure of work of breathing in COVID-19 based on Oxygen Delivery Device, Oxygen Saturation and respiratory rate and accessory muscle use with 0-3 Mild, 4-6 Moderate and 7-10 Severe
Measure: Work of breathing assessment (Respiratory distress scale) Time: Immediately before and during interventionDescription: Substudy examining use of bioimpedance as a surrogate measure of lung edema following prone positioning
Measure: Changes in bioimpedance measures of lung edema in patients in PP Time: During interventionDescription: Rescue awake prone positioning in control patients in response to hypoxia
Measure: Use of awake prone positioning as a rescue intervention in control patients Time: Up to 28 days post randomisationA pilot study to investigate the effects of the prone positioning (PP) on hospital patients diagnosed with COVID-19 pneumonia. Investigators that early self-proning may prevent intubation and improve mortality in patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2). Up to 100 participants with a primary diagnosis of confirmed COVID-19 pneumonia will be enrolled to the study. All participants will be screened and those that meet inclusion and exclusion criteria will be enrolled to one of two groups: one with prone positioning (on the belly) and the other with standard supine positioning (on the back). The patient and nursing staff will monitor times spent in various positions. Outcome measures include incidence of intubation, max oxygen requirements, length of hospital stay, ventilator-free days, worsening of oxygenation saturation, and mortality.
Description: Incidence of intubation
Measure: Incidence of intubation Time: Through study completion, an average of 6 daysDescription: Measure of maximum oxygen requirements
Measure: Maximum oxygen requirement Time: Through study completion, an average of 6 daysDescription: Measured in days of hospitalization
Measure: Length of Stay Time: Through study completion, an average of 6 daysDescription: Measured in days not on a ventilator
Measure: Ventilator-free days Time: Through study completion, an average of 6 daysDescription: Whether or not the participant met treatment failure descriptions
Measure: Treatment failure of prone positioning due to worsening SpO2 status while prone Time: Through study completion, an average of 6 daysDescription: Whether or not the participant died while hospitalized
Measure: Mortality Time: Through study completion, an average of 6 days