Respiratory failure & ventilation
Impact of awake prone positioning duration on intubation or mortality in COVID-19 patients with acute respiratory failure: secondary analysis of a randomized clinical trial
Authors' conclusion
A longer daily APP duration was associated with a reduced risk of APP failure in COVID-19-related AHRF patients, and the optimal APP duration was 8-12 h per day.
Study context
- Population
- Nonintubated COVID-19 patients with acute hypoxemic respiratory failure (AHRF)409 randomized
- Participants
- 408 patients
- Comparison
- Longer vs shorter daily awake prone positioning duration
- Primary endpoint
- Time from randomization to APP failure:
- Tracheal intubation
- Mortality
- Follow-up
- 28 days
Methodological detailstime-dependent Cox proportional hazards regression
- Time-dependent Cox proportional hazards regression
Primary result
As reported in the abstract
APP failure
Hazard ratio (95% CI)P value
Longer daily APP durationsignificant only during first 3 days after randomization
0.93(0.88–0.98)
<8 h vs 8 to 12 h
2.44(1.21–4.92)
>12 h vs 8 to 12 h
1.03(0.51–2.10)
P = 0.932- Patients with awake prone positioning (APP) failure
- 105 (25.7%)
- Nonlinear relationship between daily APP duration and risk of APP failure
- P = 0.015 for nonlinearity
Original publication
Impact of awake prone positioning duration on intubation or mortality in COVID-19 patients with acute respiratory failure: secondary analysis of a randomized clinical trial. Ann Intensive Care. Published 23 June 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →