6/29/23, 1:45 AM Prone-Supine II Pathway Feedback Search Clinical Topics Home Studies Prone-Supine II Prone-Supine II Disease Acute respiratory distress syndr Trial question Is prone positioning superior to supine positioning in patients with moderate and severe ARDS? Study design Multi-center Open label RCT Population Characteristics of study participants 29.0% female N = 342 71.0% male 342 patients (98 female, 244 male) Inclusion criteria: adult patients with moderate and severe ARDS Key exclusion criteria: age < 16 years; > 72 hours since the diagnosis of ARDS; solid organ or BMT; contraindication to prone positioning including intracranial hypertension and spine or pelvic fractures Interventions N=168 prone positioning (face down position 20 hours/day) N=174 supine positioning (face up position) Primary outcome Death at day 28 https://web.pathway.md/studies/recyYYuzx6bUhMmkJ 1/2 6/29/23, 1:45 AM Prone-Supine II Pathway 32.8 % 32.8 31 24.6 % 16.4 % 8.2 % No significant difference 0.0 % Prone positioning Supine positioning No significant difference in death at day 28 (31% vs. 32.8%; RR 0.97, 95% CI 0.84 to 1.13) Secondary outcomes No significant difference in death in the ICU (38.1% vs. 42%; RR 0.94, 95% CI 0.79 to 1.12) No significant difference in death at 6 months (47% vs. 52.3%; RR 0.9, 95% CI 0.73 to 1.11) No significant difference in sequential organ failure assessment score (6.7 vs. 6.8; AD -0.1, 95% CI -1.21 to 1.01) Safety outcomes No significant difference in displacement of thoracotomy tube. Significant differences in need for increased sedation or muscle relaxants (80.4% vs. 56.3%), airway obstruction (50.6% vs. 33.9%), transient desaturation (63.7% vs. 50.6%). Conclusion In adult patients with moderate and severe ARDS, prone positioning was not superior to supine positioning with respect to death at day 28. Reference Paolo Taccone, Antonio Pesenti, Roberto Latini et al. Prone positioning in patients with moderate and severe acute respiratory distress syndrome: a randomized controlled trial. JAMA. 2009 Nov 11;302(18):1977-84. Open reference URL https://web.pathway.md/studies/recyYYuzx6bUhMmkJ 2/2