{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:54:43Z","timestamp":1790168083557,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prone positioning improves oxygenation in adults with acute respiratory distress syndrome (ARDS) and has been extensively applied in intensive care units (ICU) during the COVID\u201019 pandemic. Although some complications due to the manoeuvre are well known, brachial plexus injury after prone positioning is reported as a rare complication and the phenomenon could be either very rare or underestimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to evaluate the effect of swimmer position during prone ventilation on the onset of brachial plexus injury in patients admitted to ICU for ARDS. The study will also evaluate the safety of prolonged prone positioning collecting data on any adverse events occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A prospective, observational cohort study will be conducted in a tertiary level ICU in the metropolitan area of Milano (Italy) specialized in advanced treatment of patients with ARDS. This observational study will report clinical data on the electromyography (EMG) and the muscle strength assessment, including comorbidities and cardio\u2010respiratory status. A baseline EMG will be performed within 2 h from the first pronation manoeuvre and immediately at the end of each pronation cycle. The functional assessment of patients will be also performed at the end of ICU stay and at hospital discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The primary outcome is to estimate the prevalence of brachial plexus injury in patients with ARDS placed in the swimmer position during prone ventilation. Secondary outcomes will also include the safety of the manoeuvre by evaluation of all adverse events classified as skin or ocular damage, loss of tube and vascular access and new pressure ulcers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>The findings of this study will contribute to understand the possible benefits\/harms of prone ventilation performed using swimmer position. Eventually, this will call for the development of specific and tailored rehabilitation programs for patients with upper limb injuries during ICU stay, including also timely follow\u2010up upon ICU\u2010discharge.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.13208","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T04:59:58Z","timestamp":1732510798000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The effect of swimmer position during prone ventilation on the onset of brachial plexus injury in the intensive care unit: A multiprofessional clinical study protocol"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2937-2698","authenticated-orcid":false,"given":"Filippo","family":"Binda","sequence":"first","affiliation":[{"name":"Department of Biomedicine and Prevention University of Rome Tor Vergata  Rome Italy"},{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6225-2989","authenticated-orcid":false,"given":"Simone","family":"Gambazza","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"},{"name":"Laboratory of Medical Statistics and Biometry \u2018Giulio A. Maccacaro\u2019 Department of Clinical Sciences and Community Health University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4511-7996","authenticated-orcid":false,"given":"Federica","family":"Marelli","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7114-7937","authenticated-orcid":false,"given":"Veronica","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0085-7015","authenticated-orcid":false,"given":"Alessandro","family":"Galazzi","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Del Monaco","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5350-8014","authenticated-orcid":false,"given":"Maurizio","family":"Vergari","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Ticozzelli","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4841-9794","authenticated-orcid":false,"given":"Mauro","family":"Panigada","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Intensive Care and Emergency Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1735-1400","authenticated-orcid":false,"given":"Giacomo","family":"Grasselli","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Intensive Care and Emergency Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"},{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5389-9879","authenticated-orcid":false,"given":"Maura","family":"Lusignani","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8552-2630","authenticated-orcid":false,"given":"Dario","family":"Laquintana","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.157.2.97\u201004023"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010020\u201002956\u2010w"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.4037\/ccn2020222"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.0994"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000122"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc13896"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008095.pub2"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.140081"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2017.03.012"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2021.103088"},{"key":"e_1_2_12_12_1","volume-title":"Prevention and Treatment of Pressure Ulcers\/Injuries: Clinical Practice Guideline. 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