Table 1 Summary of the literature on extended prone positioning for non-COVID-related ARDS
From: Extended prone positioning for intubated ARDS: a review
References | Chan et al. [17] | Romero et al. [40] | Lee et al. [41] | Miyamoto et al. [30] | Lee et al. [42] |
|---|---|---|---|---|---|
Etiology | Community-acquired pneumonia | Community-acquired pneumonia | Mostly community-acquired pneumonia | Community-acquired pneumonia and sepsis | Pulmonary and non-pulmonary ARDS |
Design | Pseudo-randomized design | Prospective observational | Retrospective | Retrospective | Retrospective |
Monocentric or multicentric | Monocentric | Monocentric | Monocentric | Monocentric | Monocentric |
Number of patients receiving extended prone positioning | 11 | 15 | 96 | 15 | 116 |
Country | Taiwan | Chile | Korea | Japan | Taiwan |
Effective prone positioning duration in hours (mean, SD or median and IQR) | ≥ 72 | 55 ± 7 | 78 ± 61 | 47 [46–67] | 66 [44–85] |
Criteria for stopping individual prone positioning sessions | At least 72 h and until SaO2 ≥ 90% and FiO2≥ 60% for 24 h | At least 48 h and until the oxygenation index (FiO2* mean airway pressure)/PaO2) ≤ 10 | PaO2/FiO2≥ 150 or FiO2requirement ≤ 0.5 at PEEP of 8 cm H2O or lower, and an improved chest radiography finding or deterioration | Not reported | At least 48 h and until PaO2/FiO2> 150 mmHg or FiO2> 50% with PEEP ≤ 8 cm H2O |
PEEP level strategy | Set to optimize oxygenation and within authorized combinations of PEEP/FiO2such as 14–16 cm of H2O for FiO2 = 0.9 | PEEP titration maneuver, then programmed at 2 cm H2O above the point at which the reduction in PEEP generated a fall in the static compliance | ≥ 8 cm H2O | Not reported | set to optimize oxygenation and within authorized combinations of PEEP/FiO2such as 14–16 cm of H2O for FiO2= 0.9 |
PEEP before PP in cm of H2O (mean, SD or median and IQR) | 13 (1) | 12 (1) | 9.8 (2.6) | 13.4 (6.9) | 14 [14–16] |
Cumulated incidence of pressure injuries | 18% | 13% | Not reported | 20% | Not reported |
Grades of the reported pressure injuries | Grade not reported | Grade ≥ II | Not reported | Grade II | Not reported |