{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T12:08:18Z","timestamp":1769170098452,"version":"3.49.0"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001782","name":"University of Melbourne","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001782","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Prone positioning may improve oxygenation in acute hypoxemic respiratory failure and was widely adopted in COVID\u201019 patients. However, the magnitude and timing of its peak oxygenation effect remain uncertain with the optimum dosage unknown. Therefore, we aimed to investigate the magnitude of the peak effect of prone positioning on the PaO<jats:sub>2<\/jats:sub>:FiO<jats:sub>2<\/jats:sub> ratio during prone and secondly, the time to peak oxygenation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multi\u2010centre, observational study of invasively ventilated adults with acute hypoxemic respiratory failure secondary to COVID\u201019 treated with prone positioning. Baseline characteristics, prone positioning and patient outcome data were collected. All arterial blood gas (ABG) data during supine, prone and after return to supine position were analysed. The magnitude of peak PaO<jats:sub>2<\/jats:sub>:FiO<jats:sub>2<\/jats:sub> ratio effect and time to peak PaO<jats:sub>2<\/jats:sub>:FIO<jats:sub>2<\/jats:sub> ratio effect was measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We studied 220 patients (mean age 54\u2009years) and 548 prone episodes. Prone positioning was applied for a mean (\u00b1SD) 3 (\u00b12) times and 16 (\u00b13) hours per episode. Pre\u2010proning PaO<jats:sub>2<\/jats:sub>:FIO<jats:sub>2<\/jats:sub> ratio was 137 (\u00b149) for all prone episodes. During the first episode. the mean PaO<jats:sub>2<\/jats:sub>:FIO<jats:sub>2<\/jats:sub> ratio increased from 125 to a peak of 196 (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Peak effect was achieved during the first episode, after 9 (\u00b15) hours in prone position and maintained until return to supine position.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In ventilated adults with COVID\u201019 acute hypoxemic respiratory failure, peak PaO<jats:sub>2<\/jats:sub>:FIO<jats:sub>2<\/jats:sub> ratio effect occurred during the first prone positioning episode and after 9\u2009h. Subsequent episodes also improved oxygenation but with diminished effect on PaO<jats:sub>2<\/jats:sub>:FIO<jats:sub>2<\/jats:sub> ratio. This information can help guide the number and duration of prone positioning episodes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14356","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T23:54:50Z","timestamp":1699574090000},"page":"361-371","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Magnitude and time to peak oxygenation effect of prone positioning in ventilated adults with COVID\u201019 related acute hypoxemic respiratory failure"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8973-661X","authenticated-orcid":false,"given":"Thomas C.","family":"Rollinson","sequence":"first","affiliation":[{"name":"Department of Intensive Care Austin Health  Melbourne Victoria Australia"},{"name":"Department of Physiotherapy Austin Health  Melbourne Victoria Australia"},{"name":"Department of Physiotherapy The University of Melbourne  Melbourne Victoria Australia"},{"name":"Institute for Breathing and Sleep  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke A.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Austin Health  Melbourne Victoria Australia"},{"name":"Department of Physiotherapy Austin Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joleen","family":"Rose","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Austin Health  Melbourne Victoria Australia"},{"name":"Department of Physiotherapy Austin Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn","family":"Eastwood","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Austin Health  Melbourne Victoria Australia"},{"name":"Data Analytics Research and Evaluation Centre The University of Melbourne and Austin Hospital  Melbourne Victoria Australia"},{"name":"Australian and New Zealand Intensive Care Research Centre Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Costa\u2010Pinto","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Austin Health  Melbourne Victoria Australia"},{"name":"Department of Critical Care The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Modra","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Austin Health  Melbourne Victoria Australia"},{"name":"Department of Critical Care The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akinori","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Austin Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Bacolas","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy Austin Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Anstey","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8613-1946","authenticated-orcid":false,"given":"Samantha","family":"Bates","sequence":"additional","affiliation":[{"name":"Department of Critical Care The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Intensive Care Western Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Bradley","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Alfred Health  Melbourne Victoria Australia"},{"name":"Department of Physiotherapy Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodi","family":"Dumbrell","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Centre Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig","family":"French","sequence":"additional","affiliation":[{"name":"Department of Critical Care The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Intensive Care Western Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angaj","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Northern Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberley","family":"Haines","sequence":"additional","affiliation":[{"name":"Department of Critical Care The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Intensive Care Western Health  Melbourne Victoria Australia"},{"name":"Department of Physiotherapy Western Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Haydon","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine St Vincent's Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"Hodgson","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Centre Monash University  Melbourne Victoria Australia"},{"name":"Department of Intensive Care Alfred Health  Melbourne Victoria Australia"},{"name":"Department of Physiotherapy Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Holmes","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine St Vincent's Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Leggett","sequence":"additional","affiliation":[{"name":"Department of Critical Care The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Intensive Care Western Health  Melbourne Victoria Australia"},{"name":"Department of Physiotherapy Western Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Forbes","family":"McGain","sequence":"additional","affiliation":[{"name":"Department of Critical Care The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Intensive Care Western Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cara","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Presneill","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Rotherham","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Said","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Northern Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meredith","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peinan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Centre Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Udy","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Centre Monash University  Melbourne Victoria Australia"},{"name":"Department of Intensive Care Alfred Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anis","family":"Chaba","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Austin Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rinaldo","family":"Bellomo","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Austin Health  Melbourne Victoria Australia"},{"name":"Data Analytics Research and Evaluation Centre The University of Melbourne and Austin Hospital  Melbourne Victoria Australia"},{"name":"Australian and New Zealand Intensive Care Research Centre Monash University  Melbourne Victoria Australia"},{"name":"Department of Critical Care The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Intensive Care Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ary Serpa","family":"Neto","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Austin Health  Melbourne Victoria Australia"},{"name":"Australian and New Zealand Intensive Care Research Centre Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-197601000-00003"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201704\u2010343OT"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010011\u20102380\u20104"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202007\u2010772OC"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1011802"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(22)01439\u20108"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2072\u20101439.2013.04.05"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214103"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0291"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010017\u20104996\u20105"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010022\u201006731\u2010z"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.23750\/abm.v91i1.9397"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/cce.0000000000000695"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010021\u201003552\u20102"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010020\u201006294\u2010x"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010020\u201006192\u20102"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13741"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.09.042"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000005354"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000004938"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010020\u201006306\u2010w"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100039\u20101685180"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010022\u201001082\u2010w"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010020\u201000683\u20107"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50883"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp\u20102019\u2010000420"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010019\u20100540\u20109"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101397"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010020\u201003116\u2010w"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010016\u20104505\u20102"},{"issue":"2","key":"e_1_2_12_32_1","first-page":"65","article-title":"A simple sequentially rejective multiple test procedure","volume":"6","author":"Holm S","year":"1979","journal-title":"Scand J Stat"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/10543406.2017.1378666"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2023.02.001"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2020.08.020"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjq.2021.02.007"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010020\u201003128\u20106"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.1056766"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201711\u20102216CP"},{"issue":"3","key":"e_1_2_12_40_1","first-page":"356","article-title":"The efficacy and safety of prone positioning in adults patients with acute respiratory distress syndrome: a meta\u2010analysis of randomized controlled trials","volume":"7","author":"Park SY","year":"2015","journal-title":"J Thorac Dis"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2021.103088"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010021\u201000853\u20101"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010023\u201007050\u20107"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931\u2010022\u201002247\u20108"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.51893\/2021.3.OA7"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2023.03.006"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202008\u20101026OC"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202302\u20100223LE"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51590"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.14356","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T06:43:00Z","timestamp":1708670580000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.14356"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,9]]},"references-count":48,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1111\/aas.14356"],"URL":"https:\/\/doi.org\/10.1111\/aas.14356","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,9]]},"assertion":[{"value":"2023-06-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}