{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:56:35Z","timestamp":1787068595405,"version":"build-2736575974"},"reference-count":37,"publisher":"European Respiratory Society (ERS)","issue":"2","license":[{"start":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T00:00:00Z","timestamp":1626307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2021,6,26]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The awake prone positioning strategy for patients with acute respiratory distress syndrome is a safe, simple and cost-effective technique used to improve hypoxaemia. We aimed to evaluate intubation and mortality risk in patients with coronavirus disease 2019 (COVID-19) who underwent awake prone positioning during hospitalisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective, multicentre observational study conducted between 1 May 2020 and 12 June 2020 in 27 hospitals in Mexico and Ecuador, nonintubated patients with COVID-19 managed with awake prone or awake supine positioning were included to evaluate intubation and mortality risk through logistic regression models; multivariable and centre adjustment, propensity score analyses, and E-values were calculated to limit confounding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      827 nonintubated patients with COVID-19 in the awake prone (n=505) and awake supine (n=322) groups were included for analysis. Fewer patients in the awake prone group required endotracheal intubation (23.6%\n                      <jats:italic>versus<\/jats:italic>\n                      40.4%) or died (19.8%\n                      <jats:italic>versus<\/jats:italic>\n                      37.3%). Awake prone positioning was a protective factor for intubation even after multivariable adjustment (OR 0.35, 95% CI 0.24\u20130.52; p&lt;0.0001, E=2.12), which prevailed after propensity score analysis (OR 0.41, 95% CI 0.27\u20130.62; p&lt;0.0001, E=1.86) and mortality (adjusted OR 0.38, 95% CI 0.26\u20130.55; p&lt;0.0001, E=2.03). The main variables associated with intubation among awake prone patients were increasing age, lower baseline peripheral arterial oxygen saturation\/inspiratory oxygen fraction ratio (\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>\n                        aO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      \/\n                      <jats:italic>F<\/jats:italic>\n                      <jats:sub>\n                        IO\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      ) and management with a nonrebreather mask.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Awake prone positioning in hospitalised nonintubated patients with COVID-19 is associated with a lower risk of intubation and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/13993003.00265-2021","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T12:11:17Z","timestamp":1626351077000},"page":"2100265","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":46,"title":["Awake prone positioning and oxygen therapy in patients with COVID-19: the APRONOX study"],"prefix":"10.1183","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8817-7000","authenticated-orcid":false,"given":"Orlando 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