|drug265||Assessing impact of COVID19 Wiki||0.58|
|drug1686||Matched Placebo Wiki||0.58|
|D045169||Severe Acute Respiratory Syndrome NIH||0.06|
|D055371||Acute Lung Injury NIH||0.06|
|D012127||Respiratory Distress Syndrome, Newborn NIH||0.05|
|D012128||Respiratory Distress Syndrome, Adult NIH||0.05|
|D018352||Coronavirus Infections NIH||0.05|
There are 3 clinical trials
The prone position during mechanical ventilation in patients with Acute Respiratory Distress Syndrome (ARDS) is able to improve oxygenation and thus reduce mortality. The objective of the study is to evaluate the ability of the prone position to increase the oxygenation of the patient with SARS-cov-2 pneumonia.
Description: Measure the ability of the prone position to increase the oxygenation of the patient with SARS-cov-2 pneumonia as a lung recruitment index.Measure: Number of patients in whom the prone position caused an increase in oxygenation Time: Until patient discharge from the hospital (approximately 1 month after enrollment)
Description: Measure the feasibility of the prone position in terms of patient comfort and health resources in a context of a national health emergency.Measure: The feasibility of prone position Time: Until patient discharge from the hospital (approximately 1 month after enrollment)
Prone position (PP) has been proved to be effective in severe ARDS patients. On the other hand, High flow nasal cannula (HFNC) may prevent intubation in hypoxemic Acute respiratory failure (ARF) patients. Our hypothesis is that the combination of PP and HFNC in patients with COVID19 induced ARDS may decrease the need of mechanical ventilation. Primary outcome: Therapeutic failure within 28 days of randomization (death or intubation). Secondary outcomes: to analyze PP feasibility and safety in HFNC patients and to analyze effectiveness in terms of oxygenation. Methods: multicentric randomized study including patients with COVID19 induced ARDS supported with HFNC. Experimental group will received HFNC and PP whereas observation group will received standard care. Optimization of non-invasive respiratory management of COVID19 induced ARDS patients may decrease the need of invasive mechanical ventilation and subsequently ICU and hospital length of stay.
Description: Therapeutic failure: death or intubationMeasure: Therapeutic failure death or intubation Time: 28 days within randomization
Description: Comfort measurement using a visual-analog scale. Presence of complications related with prone position and the use of high-flow nasal cannula: Skin ulcers. Intravascular lines displacement HFNC related events (hot air feeling, nasal lesions)Measure: Feasibility and safety of prone position in HFNC patients Time: 28 days within randomization
Description: Evolution of the oxygenation (SpO2/FiO2) in prone position. Efficacy Length of HFNC therapy Length of ICU stay Length of mechanical ventilation (in those who require intubation) ICU and hospital mortalityMeasure: Efficacy of prone position in HFNC patients Time: 28 days within randomization
The prone position strategy for patients with acute respiratory distress syndrome (ARDS) is simple and cost-effective from the first description on its use in patients with acute respiratory failure to improve hypoxemia. Different studies have investigated its safety and efficacy in various clinical settings, demonstrating that its early use in combination with non-invasive mechanical ventilation (NIV) or high-flow oxygen therapy can reduce intubation rate and mortality in ARDS. In the Coronavirus disease 2019 (COVID-19) pandemic, high-value medicine and resource optimization are critical.
Description: Relationship between awake prone position and the tracheal intubationMeasure: To analyze the relationship between the prone position and the need for orotracheal intubation. Time: 3 months
Description: See the relationship between the awake prone position and the SaO2/FiO2 INDEXMeasure: The impact of the prone position on the partial oxygen saturation / inspired oxygen fraction index (SaO2 / FiO2). Time: 3 months
Description: Determine the free hours without the need for orotracheal intubation of patients in the prone position.Measure: Determine the free hours without the need for orotracheal intubation of patients in the prone position. Time: 3 months