Respiratory failure & ventilation
Effectiveness of bundle of care on tolerance of awake-prone positioning in patients with acute respiratory failure. A multicenter observational study
Authors' conclusion
In the evaluated population of patients with COVID-19-related ARF, implementing a bundle-of-care strategy was associated with a longer AW-PP exposure and a reduced risk of endotracheal intubation.
Study context
- Population
- Patients with COVID-19-related acute respiratory failure (ARF) requiring high-flow nasal oxygen (HFNO), encouraged to awake prone positioning
- Participants
- 499 patients
- Comparison
- Bundle of care vs no bundle
- Bundlen = 197
- Controln = 302reference
- Primary endpoint
- Duration of awake prone positioning (hours/day)
Methodological detailsInverse probability of treatment weighting (IPTW), double-robust, mixed-effects model, Directed acyclic graphs used to identify variables related to exposure and outcomes
- IPTW
- Double-robust
- Mixed-effects model
- Directed acyclic graphs used to identify variables related to exposure and outcomes
Primary result
As reported in the abstract
Awake prone positioning duration
Regression coefficient
- IPTW
- 3.39 (95% CI 1.67–5.11)
- DR
- 3.35 (95% CI 1.55–5.14)
- Traditional regression (TR)
- 3.95 (95% CI 2.63–5.28)
- Mixed-effects model (MEM)
- 3.72 (95% CI 2.5–4.94)
Secondary outcomes
Endotracheal intubation
- OR (95% CI), IPTW
- 0.34 (0.15-0.76)
- OR (95% CI), DR
- 0.23 (0.10-0.50)
- OR (95% CI), TR
- 0.42 (0.23-0.77)
- OR (95% CI), MEM
- 0.48 (0.16-0.49)
- Exposure (bundle) vs no bundle (control)
In-hospital mortality
- OR (95% CI), IPTW
- 0.38 (0.11-1.27)
- OR (95% CI), DR
- 0.43 (0.14-1.26)
- OR (95% CI), TR
- 0.47 (0.22-0.91)
- OR (95% CI), MEM
- 0.46 (0.12-1.43)
- Exposure (bundle) vs no bundle (control)
Original publication
Effectiveness of bundle of care on tolerance of awake-prone positioning in patients with acute respiratory failure. A multicenter observational study. Intensive Care Med. Published 17 February 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →