Name (Synonyms) | Correlation | |
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D012128 | Respiratory Distress Syndrome, Adult NIH | 0.08 |
Name (Synonyms) | Correlation |
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There is one clinical trial.
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 randomisation