6/29/23, 1:45 AM PROSEVA Pathway Feedback Search Clinical Topics Home Studies PROSEVA PROSEVA Disease Acute respiratory distress syndr Trial question What is the role of prone positioning in patients with severe ARDS? Study design Multi-center Open label RCT Population Characteristics of study participants 32.0% female N = 466 68.0% male 466 patients (148 female, 318 male) Inclusion criteria: patients undergoing mechanical ventilation for severe ARDS Key exclusion criteria: contraindication for prone positioning, lung transplantation, underlying disease with a life expectancy of < 1 year, or end-of-life decision before inclusion Interventions N=237 performing prone-positioning sessions (within the first hour after randomization for at least 16 consecutive hours) N=229 standard supine positioning (remained in semirecumbent position) Primary outcome Death at 28 days https://web.pathway.md/studies/recqOLpJSjAuDgk7n 1/2 6/29/23, 1:45 AM PROSEVA Pathway 32.8 % 32.8 24.6 % 16.4 % 16 Significant decrease 8.2 % NNT = 6 0.0 % Performing prone-positioning sessions Standard supine positioning Significant decrease in death at 28 days (16% vs. 32.8%; HR 0.39, 95% CI 0.25 to 0.63) Secondary outcomes Significant decrease in death at 90 days (23.6% vs. 41%; HR 0.44, 95% CI 0.29 to 0.67) Significant decrease in successful extubation at 90 day (80.5% vs. 65%; HR 0.45, 95% CI 0.29 to 0.7) Safety outcomes No significant differences in overall incidence of complications, with the exception of cardiac arrest, which was more common in the supine group. Conclusion In patients undergoing mechanical ventilation for severe ARDS, performing prone-positioning sessions were superior to standard supine positioning with respect to death at 28 days. Reference Guerin C, Reignier J, Richard JC et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med. 2013 Jun 6;368(23):2159-68. Open reference URL https://web.pathway.md/studies/recqOLpJSjAuDgk7n 2/2