{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:40:14Z","timestamp":1782891614823,"version":"3.54.5"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In patients with COVID-19-related acute respiratory failure (ARF), awake prone positioning (AW-PP) reduces the need for intubation in patients treated with high-flow nasal oxygen (HFNO). However, the effects of different exposure times on clinical outcomes remain unclear. We evaluated the effect of AW-PP on the risk of endotracheal intubation and in-hospital mortality in patients with COVID-19-related ARF treated with HFNO and analyzed the effects of different exposure times to AW-PP.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This multicenter prospective cohort study in six ICUs of 6 centers in Argentine consecutively included patients\u2009&gt;\u200918\u00a0years of age with confirmed COVID-19-related ARF requiring HFNO from June 2020 to January 2021. In the primary analysis, the main exposure was awake prone positioning for at least 6\u00a0h\/day, compared to non-prone positioning (NON-PP). In the sensitivity analysis, exposure was based on the number of hours receiving AW-PP. Inverse probability weighting\u2013propensity score (IPW-PS) was used to adjust the conditional probability of treatment assignment. The primary outcome was endotracheal intubation (ETI); and the secondary outcome was hospital mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>During the study period, 580 patients were screened and 335 were included; 187 (56%) tolerated AW-PP for [median (p25\u201375)] 12 (9\u201316) h\/day and 148 (44%) served as controls. The IPW\u2013propensity analysis showed standardized differences\u2009&lt;\u20090.1 in all the variables assessed. After adjusting for other confounders, the OR (95% CI) for ETI in the AW-PP group was 0.36 (0.2\u20130.7), with a progressive reduction in OR as the exposure to AW-PP increased. The adjusted OR (95% CI) for hospital mortality in the AW-PP group\u2009\u2265\u20096\u00a0h\/day was 0.47 (0.19\u20131.31). The exposure to prone positioning\u2009\u2265\u20098\u00a0h\/d resulted in a further reduction in OR [0.37 (0.17\u20130.8)].<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In the study population, AW-PP for\u2009\u2265\u20096\u00a0h\/day reduced the risk of endotracheal intubation, and exposure\u2009\u2265\u20098\u00a0h\/d reduced the risk of hospital mortality.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13054-021-03881-2","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T14:02:48Z","timestamp":1641564168000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Impact of exposure time in awake prone positioning on clinical outcomes of patients with COVID-19-related acute respiratory failure treated with high-flow nasal oxygen: a multicenter cohort 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Minerva Anestesiol. 2021. https:\/\/doi.org\/10.23736\/S0375-9393.21.15864-X.","journal-title":"Minerva Anestesiol"}],"container-title":["Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13054-021-03881-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13054-021-03881-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13054-021-03881-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T14:16:53Z","timestamp":1641565013000},"score":1,"resource":{"primary":{"URL":"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/s13054-021-03881-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,7]]},"references-count":39,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["3881"],"URL":"https:\/\/doi.org\/10.1186\/s13054-021-03881-2","relation":{},"ISSN":["1364-8535"],"issn-type":[{"value":"1364-8535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,7]]},"assertion":[{"value":"15 October 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 January 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Internal Review Board from the 6 centers approved the study including waived informed consent (Universidad Austral Comit\u00e9 Institucional de Evaluaci\u00f3n N\u00b020-072; Comit\u00e9 de \u00c9tica en Investigaci\u00f3n SATI for Trinidad Palermo; Comit\u00e9 de Docencia e Investigaci\u00f3n Sanatorio Cl\u00ednica Modelo de Mor\u00f3n; Comit\u00e9 de \u00c9tica e Investigaci\u00f3n Hospital Alem\u00e1n; Consejo Institucional de Revisi\u00f3n de Estudios de Investigaci\u00f3n Hospital Privado de Comunidad N\u00ba 2919\/2143\/2020; Comit\u00e9 de \u00c9tica en Investigaci\u00f3n Cl\u00ednica Olivos). The interventions carried out were part of the usual practice at each center, and the researchers guaranteed confidentiality of their patient\u2019s information.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The manuscript does not contain any individual person\u2019s data in any form.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"AT is Consultant of Pfizer, Poliphor, MSD, Jansen OM Pharma. MB received lecture fees from Tecme S.A. and MEDIX Medical Devices S.R.L. Argentina. The rest of the authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16"}}