6/29/23, 1:45 AM Prone-Supine Pathway Feedback Search Clinical Topics Home Studies Prone-Supine Prone-Supine Disease Acute respiratory distress syndr Trial question Is the prone position superior to the supine position in patients with acute respiratory failure? Study design Multi-center Open label RCT Population Characteristics of study participants 30.0% female N = 304 70.0% male 304 patients (90 female, 214 male) Inclusion criteria: patients with acute lung injury or the ARDS Key exclusion criteria: age < 16 years; contraindication to prone positioning; cardiogenic pulmonary edema; cerebral edema; intracranial hypertension; fractures of the spine; severe hemodynamic instability Interventions N=152 prone position (face down position for 6 hours/day for 10 days) N=152 supine position (face up position) Primary outcome Death at 10 days https://web.pathway.md/studies/recyaSFlXUnnfVin2 1/2 6/29/23, 1:45 AM Prone-Supine Pathway 25.0 % 25 21.1 18.8 % 12.5 % 6.3 % No significant difference 0.0 % Prone position Supine position No significant difference in death at 10 days (21.1% vs. 25%; RR 0.84, 95% CI 0.56 to 1.27) Secondary outcomes No significant difference in death at the time of discharge from the ICU (50.7% vs. 48%; RR 1.05, 95% CI 0.84 to 1.32) No significant difference in death at 6 months (62.5% vs. 58.6%; RR 1.06, 95% CI 0.88 to 1.28) Significant increase in improvement in the ratio of partial pressure of arterial oxygen to FiO2 (63 vs. 44.6; AD 18.4, 95% CI 2.88 to 33.92) Safety outcomes No significant difference in complications related to positioning. Conclusion In patients with acute lung injury or the ARDS, prone position was not superior to supine position with respect to death at 10 days. Reference L Gattinoni, G Tognoni, A Pesenti et al. Effect of prone positioning on the survival of patients with acute respiratory failure. N Engl J Med. 2001 Aug 23;345(8):568-73. Open reference URL https://web.pathway.md/studies/recyaSFlXUnnfVin2 2/2