{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:43:44Z","timestamp":1787319824846,"version":"build-2736575974"},"reference-count":14,"publisher":"AACN Publishing","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mechanical ventilation and prone positioning are high-risk procedures for patients and health care team members, increasing patients\u2019 risk of secondary infection and pressure injuries, as well as increasing staff workload and risk of injury or contracting infectious diseases. Verticalization therapy is the practice of controlled, in-bed, upright positioning. Previous research showed increases in oxygenation during verticalization therapy, which suggests that verticalization therapy may be beneficial in patients with respiratory failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the safety and feasibility of verticalization therapy in patients experiencing respiratory distress, including patients with COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A convenience sample of adult patients in the medical respiratory intensive care unit at a mid-Atlantic urban academic medical center received up to 2 verticalization therapy sessions daily for a goal of 30 to 120 minutes each.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study aimed to enroll 15 participants, but suspended recruitment after 6 because of clinical team concerns that some participants were experiencing hypotension and decreases in oxygen saturation during verticalization, as well as lack of adequate nursing staff time. Most participants tolerated verticalization therapy, but one participant\u2019s initial verticalization therapy session was stopped at 30\u00b0 because of hypotension and desaturation. The unit lacked nursing staff needed to consistently verticalize participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The small number of participants limits interpretation of study findings. Future studies should consider baseline critical illness severity and a slower rate of verticalization. Although it is unclear whether verticalization therapy decreases demands on physicians, advanced practice providers, and respiratory therapists, it clearly increased nursing workload in this study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4037\/ajcc2025291","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T21:03:38Z","timestamp":1740776618000},"page":"145-149","source":"Crossref","is-referenced-by-count":3,"title":["Pulmonary-Focused Verticalization Therapy in Patients Experiencing Respiratory Failure"],"prefix":"10.4037","volume":"34","author":[{"given":"Heather","family":"Fudala","sequence":"first","affiliation":[{"name":"Heather Fudala is nursing research program director, Virginia Commonwealth University Health System, Richmond, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelly","family":"Orr","sequence":"additional","affiliation":[{"name":"Shelly Orr is director of clinical research operations, Virginia Commonwealth University (VCU) Health System and affiliate faculty, VCU Wright Center for Clinical & Translational Research, Richmond, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Winn","sequence":"additional","affiliation":[{"name":"Elisa Winn is wound care team program manager, Virginia Commonwealth University Health System, Richmond, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Roberson","sequence":"additional","affiliation":[{"name":"Audrey Roberson was nurse manager, medical respiratory intensive care unit, Virginia Commonwealth University Health System, Richmond, Virginia. She is now an assistant professor, Virginia Commonwealth University School of Nursing, Richmond, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Peay","sequence":"additional","affiliation":[{"name":"Alice Peay is director of rehab services, Virginia Commonwealth University Health System, Richmond, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Yajnik","sequence":"additional","affiliation":[{"name":"Vishal Yajnik is director, neuroscience intensive care unit and associate professor, Anesthesiology and Neurosurgery Division of Critical Care at Virginia Commonwealth University Health System, Richmond, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"2","key":"2025030102030853700_b1-0340145","doi-asserted-by":"crossref","first-page":"656","DOI":"10.3390\/ijerph17020656","article-title":"Risk factors of pneumonia associated with mechanical ventilation","volume":"17","author":"K\u00f3zka","year":"2020","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"2025030102030853700_b2-0340145","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/cc13775","article-title":"Ventilator-associated pneumonia in the ICU","volume":"18","author":"Kalanuria","year":"2014","journal-title":"Crit Care"},{"issue":"3","key":"2025030102030853700_b3-0340145","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/01.ASW.0000732896.29121.06","article-title":"Risk factors of endotracheal intubation-related pressure injury among patients admitted to the ICU","volume":"34","author":"Qin","year":"2021","journal-title":"Adv Skin Wound Care"},{"issue":"7","key":"2025030102030853700_b4-0340145","doi-asserted-by":"publisher","first-page":"e16796","DOI":"10.7759\/cureus.16796","article-title":"Endotracheal tube fastening device-related facial pressure ulcers","volume":"13","author":"Rastogi","year":"2021","journal-title":"Cureus"},{"issue":"9","key":"2025030102030853700_b5-0340145","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1016\/j.bjps.2020.12.057","article-title":"Prone position pressure sores in the COVID-19 pandemic: the Madrid experience","volume":"74","author":"Ibarra","year":"2021","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"2","key":"2025030102030853700_b6-0340145","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1513\/AnnalsATS.202005-571OC","article-title":"Improving prone positioning for severe acute respiratory distress syndrome during the COVID-19 pandemic: an implementation-mapping approach","volume":"18","author":"Klaiman","year":"2021","journal-title":"Ann Am Thorac Soc"},{"issue":"10","key":"2025030102030853700_b7-0340145","doi-asserted-by":"publisher","first-page":"e10767","DOI":"10.7759\/cureus.10767","article-title":"Factors influencing prone positioning in treating acute respiratory distress syndrome and the effect on mortality rate","volume":"12","author":"Dardeir","year":"2020","journal-title":"Cureus"},{"key":"2025030102030853700_b8-0340145","volume-title":"The Impact of COVID-19 on Health and Care Workers: A Closer Look at Deaths","author":"World Health Organization","year":"2021"},{"key":"2025030102030853700_b9-0340145","first-page":"104","article-title":"Utilization of the Kreg lift bed to promote mobilization in the intubated patient in the medical intensive cardiac care unit","author":"Duey"},{"issue":"10","key":"2025030102030853700_b10-0340145","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1007\/s00134-006-0299-y","article-title":"Effects of vertical positioning on gas exchange and lung volumes in acute respiratory distress syndrome","volume":"32","author":"Richard","year":"2006","journal-title":"Intensive Care Med"},{"key":"2025030102030853700_b11-0340145","first-page":"A5033","article-title":"Physiological effects and safety of bed verticalization in patients with acute respiratory distress syndrome","volume":"205","author":"Bouchant","year":"2022","journal-title":"Am J Respir Crit Care Med"},{"key":"2025030102030853700_b12-0340145","article-title":"Feasibility of upright bed position in ARDS patients","author":"Qutob"},{"key":"2025030102030853700_b13-0340145","unstructured":"Kreg Therapeutics. 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