Article Dans Une Revue Journal of Critical Care Année : 2023

Awake prone positioning in acute hypoxaemic respiratory failure: An international expert guidance

Jian Luo
  • Fonction : Auteur
Thérèse Allen
  • Fonction : Auteur

Résumé

Background: Awake prone positioning (APP) of non-intubated patients with acute hypoxaemic respiratory failure (AHRF) has been inconsistently adopted into routine care of patients with COVID-19, likely due to apparent conflicting evidence from recent trials. This short guideline aims to provide evidence-based recommendations for the use of APP in various clinical scenarios.Methods: An international multidisciplinary panel, assembled for their expertise and representativeness, and supported by a methodologist, performed a systematic literature search, summarized the available evidence derived from randomized clinical trials, and developed recommendations using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology.Results: The panel strongly recommends that APP rather than standard supine care be used in patients with COVID-19 receiving advanced respiratory support (high-flow nasal cannula, continuous positive airway pressure or non-invasive ventilation). Due to lack of evidence from randomized controlled trials, the panel provides no recommendation on the use of APP in patients with COVID-19 supported with conventional oxygen therapy, nor in patients with AHRF due to causes other than COVID-19.Conclusion: APP should be routinely implemented in patients with COVID-19 receiving advanced respiratory support.

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Dates et versions

hal-04792619 , version 1 (20-11-2024)

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Ivan Pavlov, Jie Li, Aileen Kharat, Jian Luo, Miguel Ibarra-Estrada, et al.. Awake prone positioning in acute hypoxaemic respiratory failure: An international expert guidance. Journal of Critical Care, 2023, 78, pp.154401. ⟨10.1016/j.jcrc.2023.154401⟩. ⟨hal-04792619⟩
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