{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:00:57Z","timestamp":1757610057306,"version":"3.44.0"},"reference-count":26,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"This work was supported by the Chinese Academy of Sciences-Wego Group Hightech Research & Development Program","award":["2019-1"],"award-info":[{"award-number":["2019-1"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,8,15]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>At present, the available evidence regarding the relationship between prone position ventilation (PPV) and tracheal injury score remains inadequate. This study seeks to gain deeper insights into the relationship between PPV and tracheal injury score in intensive care unit (ICU) patients with invasive ventilation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>A secondary analysis of a prospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Our study was conducted in a Class III hospital in Hebei Province, China.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Patients aged over 18 years admitted to the ICU between 31 May 2020 and 10 November 2023 with a tracheal tube and expected to be on the tube for more than 24 hours.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>The primary outcome was tracheal injury score, assessed via fibreoptic bronchoscopy for hyperaemia, ischaemia, ulcers and perforation. Lesions were classified as moderate, severe or confluent based on extent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 149 selected participants, the average age was 58.4\u00b116.2 years, with 65.8% being male. The results of adjusted linear regression showed that PPV was associated with tracheal injury scores (\u03b2: 5.33; 95%\u2009CI 3.84 to 6.82). Subgroup analysis indicated that PPV is significantly associated with an increased tracheal injury score, and this association remains consistent across different ages, sex, septic shock and non-septic shock groups, and duration of intubation &lt;8\u2009days and \u22658\u2009days groups (p&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our findings suggest PPV may be associated with tracheal injury score, highlighting a potential link between PPV and tracheal injury score.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>ChiCTR2000037842, registered 3 September 2020 retrospectively registered, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.chictr.org.cn\/showproj.html?proj=57011\">https:\/\/www.chictr.org.cn\/showproj.html?proj=57011<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-096440","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:55:40Z","timestamp":1756904140000},"page":"e096440","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association between prone position ventilation and tracheal injury score in intensive care unit patients with invasive ventilation: a secondary analysis of a prospective cohort study in China"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4776-6084","authenticated-orcid":false,"given":"Pei","family":"Zhang","sequence":"first","affiliation":[{"name":"Intensive Care Unit of Department of Anesthesiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, 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