Huang Dunbing, Tian Huan, Song Wei, Wang Jiaqi, Yao Zizhe, Xiong Lize, Jiang Cai, Zhang Anren, Ke Xiaohua
Department of Rehabilitation Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, No.1279 Sanmen Road, Hongkou District, Shanghai, China.
School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Eur J Med Res. 2024 Dec 30;29(1):636. doi: 10.1186/s40001-024-02252-1.
Our aim is to investigate the effects of a innovative modular prone positioning tools on patients with acute respiratory distress syndrome (ARDS) caused by COVID-19 during awake prone positioning (AW-PP).
This prospective randomized controlled study initially enrolled 168 patients with COVID-19 due to ARDS. However, 92 were subsequently disqualified, leaving 76 patients who were randomly assigned to either the observation group (n = 38) or the control group (n = 38). The observation group utilized innovative modular prone positioning tools for non-invasive respiratory support (NIRS), while the control group used soft pillows for the same treatment. Data were collected on comfort levels, adverse events, and efficacy indicators. Additionally, the comfort, incidence of adverse events, and treatment efficacy in both groups were evaluated.
The observation group had shorter the daily duration spent on executing the AW-PP (2.74 ± 0.86 min vs. 4.64 ± 1.02 min, P < 0.001), longer the daily total AW-PP (8.52 ± 1.01 h vs. 6.03 ± 0.66 h, P < 0.001), longer the daily duration until the first position adjustment (59.89 ± 12.73 min vs. 36.57 ± 8.69 min, P < 0.001), and lower the daily frequency of position adjustments during the AW-PP (11.03 ± 2.67 vs. 17.95 ± 2.58, P < 0.001) in comparison with the control group. No significant differences were observed in intubation rates, mortality, the daily number of hours under HFNO and NIV, escalated to NIV from HFNO, and hospital length of stay between the groups (P > 0.05). However, the observation group experienced significantly fewer adverse events, including kinking NIRS circuit, pain, shortness of breath, dizziness, and pressure ulcers (P < 0.05).
Innovative modular prone positioning tools improved efficiency, comfort, and reduced adverse events during AW-PP but did not affect intubation rates or mortality.
我们的目的是研究一种创新的模块化俯卧位工具对新型冠状病毒肺炎（COVID-19）所致急性呼吸窘迫综合征（ARDS）患者在清醒俯卧位通气（AW-PP）期间的影响。
这项前瞻性随机对照研究最初纳入了168例因ARDS患COVID-19的患者。然而，随后有92例被排除，剩下76例患者被随机分为观察组（n = 38）和对照组（n = 38）。观察组使用创新的模块化俯卧位工具进行无创呼吸支持（NIRS），而对照组使用软枕进行相同治疗。收集舒适度、不良事件和疗效指标的数据。此外，评估两组的舒适度、不良事件发生率和治疗效果。
与对照组相比，观察组执行AW-PP的每日时长更短（2.74±0.86分钟对4.64±1.02分钟，P<0.001），每日总的AW-PP时间更长（8.52±1.01小时对6.03±0.66小时，P<0.001），首次体位调整前的每日时长更长（59.89±12.73分钟对36.57±8.69分钟，P<0.001），且AW-PP期间每日体位调整频率更低（11.03±2.67对17.95±2.58，P<0.001）。两组在插管率、死亡率、每日高流量鼻导管吸氧（HFNO）和无创通气（NIV）时长、从HFNO升级至NIV以及住院时间方面未观察到显著差异（P>0.05）。然而，观察组发生的不良事件显著更少，包括NIRS管路打折、疼痛、呼吸急促、头晕和压疮（P<0.05）。
创新的模块化俯卧位工具提高了AW-PP期间的效率、舒适度并减少了不良事件，但不影响插管率或死亡率。
