Acute Respiratory Failure
Conditions
Brief summary
Awake prone positioning has been used widely for patients with COVID-19.Many research results are not uniform on the key issue of whether the prognosis of patients can be improved，and most of the subjects were patients with SARS-CoV-2 infected who are not intubated.The investigators will conduct a prospective observational study on patients with acute respiratory failure induced by various causes to determine whether awake prone position can reduce the need to upgrade to invasive mechanical ventilation and improve the prognosis of patients compared with standard treatment.
Interventions
None listed
Sponsors
First Affiliated Hospital of Zhejiang University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* 1.Older than 17 years, admitted to the ICU;2.Patients with acute respiratory failure meet the following conditions：①Under the condition of breathing air at rest, PaO2 of subjects is lower than 60mmHg and/or PaCO2 is higher than 50mmHg; ②Under the support of COT and HFNC, PaO2/FiO2 of the subject is less than 250; ③ Under the support of NIV ;
Exclusion criteria
* 1.Refusing to cooperate with active treatment; 2.Immediate need for intubation as determined by the treating team.3Patients with hemodynamic instability and moderate to high dose of vasopressors (norepinephrine dose ≥ 0.15 mcg/kg/min)；4.Contraindication to PP (e.g. vomiting, abdominal wound, unstable pelvic/spinal lesions, pregnancy \>20/40 gestation, severe brain injury)；
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Endotracheal intubation rate | 28 days | Percentage of patients in each group whose respiratory support means are upgraded to endotracheal intubation |
| Mortality | 28 days | Death |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total days of prone positioning therapy | 28 days | Total days of prone positioning therapy |
| Non-invasive ventilation days | 28 days | Number of days not receiving non-invasive mechanical ventilation |
| Total hours of prone position at day | 28 days | Total hours of prone position at day |
| Total length of stay in ICU and hospital | 28 days | Total length of stay in ICU and hospital |
| Change in the ROX-index 1-hour after first prone session | 1 hour | The change in the Ratio of SpO2/FiO2 to respiratory rate (ROX-index) |
| Total number of prone sessions at day | 28 days | Total number of prone sessions at day |
Outcome results
None listed