PRONE POSITION TRIAL
PRONE POSITION LICENSE

3-6 In several previous trials, these physiological benefits did not translate into better patient outcomes, since no significant improvement was observed in patient survival with prone positioning. 1,2 Furthermore, several lines of evidence have shown that prone positioning could prevent ventilator-induced lung injury. Randomized, controlled trials have confirmed that oxygenation is significantly better when patients are in the prone position than when they are in the supine position. Prone positioning has been used for many years to improve oxygenation in patients who require mechanical ventilatory support for management of the acute respiratory distress syndrome (ARDS). Prone Positioning of Patients with the Acute Respiratory Distress Syndrome (ARDS) (05:11) (Funded by the Programme Hospitalier de Recherche Clinique National 20 of the French Ministry of Health PROSEVA number, NCT00527813.) Introduction In patients with severe ARDS, early application of prolonged prone-positioning sessions significantly decreased 28-day and 90-day mortality. The incidence of complications did not differ significantly between the groups, except for the incidence of cardiac arrests, which was higher in the supine group. Unadjusted 90-day mortality was 23.6% in the prone group versus 41.0% in the supine group (P<0.001), with a hazard ratio of 0.44 (95% CI, 0.29 to 0.67). The hazard ratio for death with prone positioning was 0.39 (95% confidence interval, 0.25 to 0.63). The 28-day mortality was 16.0% in the prone group and 32.8% in the supine group (P<0.001). ResultsĪ total of 237 patients were assigned to the prone group, and 229 patients were assigned to the supine group. The primary outcome was the proportion of patients who died from any cause within 28 days after inclusion. Severe ARDS was defined as a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen (FiO 2) of less than 150 mm Hg, with an FiO 2 of at least 0.6, a positive end-expiratory pressure of at least 5 cm of water, and a tidal volume close to 6 ml per kilogram of predicted body weight. In this multicenter, prospective, randomized, controlled trial, we randomly assigned 466 patients with severe ARDS to undergo prone-positioning sessions of at least 16 hours or to be left in the supine position. We evaluated the effect of early application of prone positioning on outcomes in patients with severe ARDS. Previous trials involving patients with the acute respiratory distress syndrome (ARDS) have failed to show a beneficial effect of prone positioning during mechanical ventilatory support on outcomes. The most trusted, influential source of new medical knowledge and clinical best practices in the world.

PRONE POSITION LICENSE

Information and tools for librarians about site license offerings. Valuable tools for building a rewarding career in health care. The authorized source of trusted medical research and education for the Chinese-language medical community. The most advanced way to teach, practice, and assess clinical reasoning skills. Information, resources, and support needed to approach rotations - and life as a resident. The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams. NEW! Peer-reviewed journal featuring in-depth articles to accelerate the transformation of health care delivery.Ĭoncise summaries and expert physician commentary that busy clinicians need to enhance patient care.

PRONE POSITION TRIAL

NEW! A digital journal for innovative original research and fresh, bold ideas in clinical trial design and clinical decision-making.