| Title: |
Effect of early and later prone positioning on outcomes in invasively ventilated COVID-19 patients with acute respiratory distress syndrome: analysis of the prospective COVID-19 critical care consortium cohort study |
| Authors: |
Simpkin, Andrew J.; McNicholas, Bairbre A.; Hannon, David; Bartlett, Robert; Chiumello, Davide; Dalton, Heidi J.; Gibbons, Kristen; White, Nicole; Merson, Laura; Fan, Eddy; Panigada, Mauro; Grasselli, Giacomo; Motos, Anna; Torres, Antoni; Barbé, Ferran; Ng, Pauline Yeung; Fanning, Jonathon P.; Nichol, Alistair; Suen, Jacky Y.; Bassi, Gianluigi Li; Fraser, John F.; Laffey, John G.; Al-Dabbous, Tala; Alfoudri, Huda; Shamsah, Mohammed; Elapavaluru, Subbarao; Berg, Ashley; Horn, Christina; Mayasi, Yunis; Schroll, Stephan; Meyer, Dan; Velazco, Jorge; Ploskanych, Ludmyla; Fikes, Wanda; Bagewadi, Rohini; Dao, Marvin; White, Haley; Berrios Laviena, Alondra; Ehlers, Ashley; Shalabi-McGuire, Maysoon; Witt, Trent; Grazioli, Lorenzo; Lorini, Luca; Grandin, E. Wilson; Nunez, Jose; Reyes, Tiago; O’Briain, Diarmuid; Hunter, Stephanie; Ramanan, Mahesh; Affleck, Julia; Hurkadli Veerendra, Hemanth; Rai, Sumeet; Russell-Brown, Josie; Nourse, Mary; Joseph, Mark; Mitchell, Brook; Tenzer, Martha; Abe, Ryuzo; Cho, Hwa Jin; Jeong, In Seok; Rahman, Nadeem; Kakar, Vivek; Brozzi, Nicolas; Mehkri, Omar; Krishnan, Sudhir; Duggal, Abhijit; Houltham, Stuart; Graf, Jerónimo; Diaz, Roderigo; Orrego, Roderigo; Delgado, Camila; González, Joyce; Sanchez, Maria Soledad; Piagnerelli, Michael; Valenzuela Sarrazin, Josefa; Zabert, A/Prof. Gustavo; Espinosa, Lucio; Delgado, Paulo; Delgado, Victoria; Bautista Rincón, Diego Fernando; Marulanda Yanten, Angela Maria; Bustamante Duque, Melissa; Brodie, Daniel; Elhazmi, Alyaa; Al-Hudaib, Abdullah; Callahan, Maria; Taufik, M. Azhari; Wardoyo, Elizabeth Yasmin; Gunawan, Margaretha; Trisnaningrum, Nurindah S; Irawany, Vera; Rayhan, Muhammad; Pesenti, Antonio; Zanella, Alberto; Colombo, Sebastiano; Martinet, Chiara; Florio, Gaetano; Antonelli, Massimo; Carelli, Simone; Grieco, Domenico L.; Asaki, Motohiro; Hoshino, Kota; Salazar, Leonardo; Mendoza Monsalve, Mary Alejandra; Laffey, John; McNicholas, Bairbre; Cosgrave, David; McCaffrey, Joseph; Bone, Allison; Hakeem, Yusuff; Winearls, James; Tallott, Mandy; Thomson, David; Arnold-Day, Christel; Cupido, Jerome; Fanie, Zainap; Miller, Malcom; Seymore, Lisa; van Straaten, Dawid; Ait Hssain, Ali; Aliudin, Jeffrey; Alqahtani, Al-Reem; Mohamed, Khoulod; Mohamed, Ahmed; Tan, Darwin; Villanueva, Joy; Zaqout, Ahmed; Kurtzman, Ethan; Ademi, Arben; Dobrita, Ana; El Aoudi, Khadija; Segura, Juliet; Giwangkancana, Gezy; Ohshimo, Shinichiro; Osatnik, Javier; Joosten, Anne; Yang, Minlan; Motos, Ana; Luna, Carlos; Arancibia, Francisco; Williams, Virginie; Noel, Alexandre; Luque, Nestor; Fantini, Marina; Jorge García, Ruth Noemi; Chicote Alvarez, Enrique; Greti, Anna; Ceccato, Adrian; Sanchez, Angel; Loza Vazquez, Ana; Roche-Campo, Ferran; Franch-Llasat, Diego; Tuazon, Divina; Amato, Marcelo; Cassimiro, Luciana; Pola, Flavio; Ribeiro, Francis; Fonseca, Guilherme; Dalton, Heidi; Desai, Mehul; Osborn, Erik; Deeb, Hala; Arcadipane, Antonio; Martucci, Gennaro; Panarello, Giovanna; Vitiello, Chiara; Bianco, Claudia; Occhipinti, Giovanna; Rossetti, Matteo; Cuffaro, Raffaele; Cho, Sung-Min; Whitman, Glenn; Shimizu, Hiroaki; Moriyama, Naoki; Kim, Jae-Burm; Kitamura, Nobuya; Gebauer, Johannes; Yokoyama, Toshiki; Al-Fares, Abdulrahman; Buabbas, Sarah; Alamad, Esam; Alawadhi, Fatma; Alawadi, Kalthoum; Tanaka, Hiro; Hashimoto, Satoru; Yamazaki, Masaki; Oh, Tak-Hyuck; Epler, Mark; Forney, Cathleen; Kruse, Louise; Feister, Jared; Williamson, Joelle; Grobengieser, Katherine; Gnall, Eric; Golden, Sasha; Caroline, Mara; Shapiro, Timothy; Karaj, Colleen; Thome, Lisa; Sher, Lynn; Vanderland, Mark; Welch, Mary; McDermott, Sherry; Brain, Matthew; Mineall, Sarah; Kimura, Dai; Brazzi, Luca; Sales, Gabriele; Montrucchio, Giorgia; Ogston, Tawnya; Nagpal, Dave; Fischer, Karlee; Lorusso, Roberto; Rangappa, Rajavardhan; Rai, Sujin; Appu, Argin; Esperatti, Mariano; Fuentes, Nora Angélica; Gonzalez, Maria Eugenia; Carton, Edmund G.; Sen, Ayan; Palacios, Amanda; Rainey, Deborah; Samoukoviv, Gordan; Campisi, Josie; Durham, Lucia; Neumann, Emily; Seefeldt, Cassandra; Falcucci, Octavio; Emmrich, Amanda; Guy, Jennifer; Johns, Carling; Potzner, Kelly; Zimmermann, Catherine; Espinal, Angelia; Buchtele, Nina; Schwameis, Michael; Korhnfehl, Andrea; Brock, Roman; Staudinger, Thomas; Stecher, Stephanie-Susanne; Barnikel, Michaela; Antón, Sófia; Pawlikowski, Alexandra; Zaaqoq, Akram; Galloway, Lan Anh; Merley, Caitlin; Csete, Marc; Quesada, Luisa; Saba, Isabela; Kasugai, Daisuke; Hiraiwa, Hiroaki; Tanaka, Taku; Marwali, Eva; Purnama, Yoel; Dewayanti, Santi Rahayu; Ardiyan; Juzar, Dafsah Arifa; Siagian, Debby; Chen, Yih-Sharng; Ogino, Mark; Ratsep, Indrek; Post, Andra-Maris; Sillaots, Piret; Krund, Anneli; Lehiste, Merili-Helen; Lepik, Tanel; Manetta, Frank; Mihelis, Effe; Sarmiento, Iam Claire; Narasimhan, Mangala; Varrone, Michael; Komats, Mamoru; Garcia-Diaz, Julia; Harmon, Catherine; Satyapriya, S. Veena; Bhatt, Amar; Mokadam, Nahush A.; Uribe, Alberto; Gonzalez, Alicia; Shi, Haixia; McKeown, Johnny; Pasek, Joshua; Fiorda, Juan; Echeverria, Marco; Moreno, Rita; Zakhary, Bishoy; Cavana, Marco; Cucino, Alberto; Foti, Giuseppe; Giani, Marco; Fumagalli, Benedetta; Castagna, Valentina; Dell’Amore, Andrea; Navalesi, Paolo; Shum, Hoi-Ping; Vuysteke, Alain; Usman, Asad; Acker, Andrew; Smood, Benjamin; Mergler, Blake; Sertic, Federico; Subramanian, Madhu; Sperry, Alexandra; Rizer, Nicolas; Burhan, Erlina; Rasmin, Menaldi; Akmal, Ernita; Sitompul, Faya; Lolong, Navy; Naivedh, Bhat; Erickson, Simon; Barrett, Peter; Dean, David; Daugherty, Julia; Loforte, Antonio; Khan, Irfan; Quraishi, Mohammed Abraar; DeSantis, Olivia; So, Dominic; Kandamby, Darshana; Mandei, Jose M.; Natanael, Hans; Lantang, Eka Yudha; Lantang, Anastasia; Wijaya, Surya Oto; Jung, Anna; Ng, George; Ng, Wing Yiu; Fang, Shu; Tabah, Alexis; Ratcliffe, Megan; Duroux, Maree; Adachi, Shingo; Nakao, Shota; Blanco, Pablo; Prieto, Ana; Sánchez, Jesús; Nicholson, Meghan; Butt, Warwick; Serratore, Alyssa; Delzoppo, Carmel; Janin, Pierre; Yarad, Elizabeth; Totaro, Richard; Coles, Jennifer; Pujo, Bambang; Balk, Robert; Vissing, Andy; Kapania, Esha; Hays, James; Fox, Samuel; Yantosh, Garrett; Mishin, Pavel; Yuliarto, Saptadi; Santoso, Kohar Hari; Djajalaksana, Susanthy; Fatoni, Arie Zainul; Fukuda, Masahiro; Liu, Keibun; Pelosi, Paolo; Battaglini, Denise; Masa Jiménez, Juan Fernando; Bastos, Diego; Gaião, Sérgio; Rusmawatiningtyas, Desy; Cho, Young-Jae; Lee, Su Hwan; Kawasaki, Tatsuya; Munshi, Laveena; Sakiyalak, Pranya; Nitayavardhana, Prompak; Seitz, Tamara; Arora, Rakesh; Kent, David; Marino, Daniel; Parwar, Swapnil; Cheng, Andrew; Miller, Jennene; Fujitani, Shigeki; Shimizu, Naoki; Madhok, Jai; Owyang, Clark; Buscher, Hergen; Reynolds, Claire; Maasikas, Olavi; Beljantsev, Aleksan; Mihnovits, Vladislav; Akimoto, Takako; Aizawa, Mariko; Horibe, Kanako; Onodera, Ryota; Hodgson, Carol; Burrell, Aidan; Young, Meredith; George, Timothy; Shekar, Kiran; McGuinness, Niki; Irvine, Lacey; Flynn, Brigid; Endo, Tomoyuki; Sugiyama, Kazuhiro; Shimizu, Keiki; Exconde, Kathleen; Ichiba, Shingo; Lussier, Leslie; Lotz, Gösta; Malfertheiner, Maximilian; Maier, Lars; Dreier, Esther; Kusumastuti, Neurinda Permata; McCloskey, Colin; Dabaliz, Al-Awwab; Elshazly, Tarek B; Smith, Josiah; Szuldrzynski, Konstanty S.; Bielański, Piotr; Wille, Keith; Murthy, Srinivas; Parhar, Ken Kuljit S.; Fiest, Kirsten M.; Codan, Cassidy; Shahid, Anmol; Fayed, Mohamed; Evans, Timothy; Garcia, Rebekah; Gutierrez, Ashley; Song, Tae; Rose, Rebecca; Bennett, Suzanne; Richardson, Denise; Peek, Giles; Arora, Lovkesh; Rappapport, Kristina; Rudolph, Kristina; Sibenaller, Zita; Stout, Lori; Walter, Alicia; Herr, Daniel; Vedadi, Nazli; Thompson, Shaun; Hoffman, Julie; Ying, Xiaonan; Kennedy, Ryan; Elhadi, Muhammed; Griffee, Matthew; Ciullo, Anna; Kida, Yuri; Ferrer Roca, Ricard; Riera, Jordi; Contreras, Sofia; Alegre, Cynthia; Kay, Christy; Fischer, Irene; Renner, Elizabeth; Taniguci, Hayato; Fraser, John; Li Bassi, Gianluigi; Suen, Jacky; Barnett, Adrian; Forsyth, Simon; Corley, Amanda; Pearse, India; Hinton, Samuel; Abbate, Gabriella; Hassan, Halah; Heinsar, Silver; Karnik, Varun A.; Ki, Katrina; O’Neill, Hollier F.; Obonyo, Nchafatso; Pimenta, Leticia Pretti; Reid, Janice D.; Sato, Kei; Vuorinen, Aapeli; Wildi, Karin S.; Wilson, Emily S.; Yerkovich, Stephanie; Lee, James; Plotkin, Daniel; Citarella, Barbara Wanjiru; Merson, Laura. |
| Contributors: |
A.J. Simpkin; B.A. Mcnichola; D. Hannon; R. Bartlett; D. Chiumello; H.J. Dalton; K. Gibbon; N. White; L. Merson; E. Fan; M. Panigada; G. Grasselli; A. Moto; A. Torre; F. Barbé; P.Y. Ng; J.P. Fanning; A. Nichol; J.Y. Suen; G.L. Bassi; J.F. Fraser; J.G. Laffey; T. Al-Dabbou; H. Alfoudri; M. Shamsah; S. Elapavaluru; A. Berg; C. Horn; Y. Mayasi; S. Schroll; D. Meyer; J. Velazco; L. Ploskanych; W. Fike; R. Bagewadi; M. Dao; H. White; A. Berrios Laviena; A. Ehler; M. Shalabi-McGuire; T. Witt; L. Grazioli; L. Lorini; E.W. Grandin; J. Nunez; T. Reye; D. O’Briain; S. Hunter; M. Ramanan; J. Affleck; H. Hurkadli Veerendra; S. Rai; J. Russell-Brown; M. Nourse; M. Joseph; B. Mitchell; M. Tenzer; R. Abe; H.J. Cho; I.S. Jeong; N. Rahman; V. Kakar; N. Brozzi; O. Mehkri; S. Krishnan; A. Duggal; S. Houltham; J. Graf; R. Diaz; R. Orrego; C. Delgado; J. González; M.S. Sanchez; M. Piagnerelli; J. Valenzuela Sarrazin; A.G. Zabert; L. Espinosa; P. Delgado; V. Delgado; D.F. Bautista Rincón; A.M. Marulanda Yanten; M. Bustamante Duque; D. Brodie; A. Elhazmi; A. Al-Hudaib; M. Callahan; M.A. Taufik; E.Y. Wardoyo; M. Gunawan; N.S. Trisnaningrum; V. Irawany; M. Rayhan; A. Pesenti; A. Zanella; S. Colombo; C. Martinet; G. Florio; M. Antonelli |
| Publisher Information: |
Springer Science and Business Media Deutschland GmbH |
| Publication Year: |
2025 |
| Collection: |
The University of Milan: Archivio Istituzionale della Ricerca (AIR) |
| Subject Terms: |
COVID-19; Cox proportional hazards model; Invasive mechanical ventilation; Prone positioning; Proning; Settore MEDS-23/A - Anestesiologia |
| Description: |
Background: Prone positioning of patients with COVID-19 undergoing invasive mechanical ventilation (IMV) is widely used, but evidence of efficacy remains sparse. The COVID-19 Critical Care Consortium has generated one of the largest global datasets on the management and outcomes of critically ill COVID-19 patients. This prospective cohort study investigated the association between prone positioning and mortality and in particular focussed on timing of treatment. Methods: We investigated the incidence, demographic profile, management and outcomes of proned patients undergoing IMV for COVID-19 in the study. We compared outcomes between patients prone positioned within 48 h of IMV to those (i) never proned, and (ii) proned only after 48 h. Results: 3131 patients had data on prone positioning, 1482 (47%) were never proned, 1034 (33%) were proned within 48 h and 615 (20%) were proned only after 48 h of commencement of IMV. 28-day (hazard ratio 0.82, 95% confidence interval [CI] 0.68, 0.98, p = 0.03) and 90-day (hazard ratio 0.81, 95% CI 0.68, 0.96, p = 0.02) mortality risks were lower in those patients proned within 48 h of IMV compared to those never proned. However, there was no evidence for a statistically significant association between prone positioning after 48 h with 28-day (hazard ratio 0.93, 95% CI 0.75, 1.14, p = 0.47) or 90-day mortality (hazard ratio 0.95, 95% CI 0.78, 1.16, p = 0.59). Conclusions: Prone positioning is associated with improved outcomes in patients with COVID-19, but timing matters. We found no association between later proning and patient outcome. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/39930162; info:eu-repo/semantics/altIdentifier/wos/WOS:001417576700001; volume:15; issue:1; firstpage:1; lastpage:11; numberofpages:11; journal:ANNALS OF INTENSIVE CARE; https://hdl.handle.net/2434/1190673 |
| DOI: |
10.1186/s13613-025-01422-6 |
| Availability: |
https://hdl.handle.net/2434/1190673; https://doi.org/10.1186/s13613-025-01422-6 |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.1F83513C |
| Database: |
BASE |