6/28/23, 10:11 PM Early Prone in ARDS Pathway Feedback Search Clinical Topics Home Studies Early Prone in ARDS Early Prone in ARDS Disease Acute respiratory distress syndr Trial question Is prone ventilation superior to supine ventilation in patients with severe ARDS? Study design Multi-center Open label RCT Population Characteristics of study participants 37.0% female N = 136 63.0% male 136 patients (50 female, 86 male) Inclusion criteria: intubated patients with severe ARDS Key exclusion criteria: relapse of > 48 hours since meeting inclusion criteria; systolic BP < 80 mmHg despite vasopressors; pelvic or spine fractures; cranial trauma, increased ICP; moribund Interventions N=76 prone ventilation (continuous ventilation in face down position for 20 hours/day) N=60 supine ventilation (ventilation in face up position) Primary outcome Death in intensive care unit 58.0 % 58 43.5 % 43 https://web.pathway.md/studies/recwZybDWMLSyioCX 1/2 6/28/23, 10:11 PM Early Prone in ARDS Pathway 29.0 % 14.5 % No significant difference 0.0 % Prone ventilation Supine ventilation No significant difference in death in the ICU (43% vs. 58%; RR 0.74, 95% CI -0.19 to 1.67) Secondary outcomes No significant difference in death in the hospital (50% vs. 62%; RR 0.81, 95% CI -0.48 to 2.1) No significant difference in length of stay in the ICU (20.5 days vs. 19.1 days; AD 1.4 days, 95% CI -5.41 to 8.21) No significant difference in pneumothorax (9.2% vs. 6.7%; RR 1.37, 95% CI -6.96 to 9.7) Safety outcomes No significant differences in pressure sores, conjunctival hemorrhage. Conclusion In intubated patients with severe ARDS, prone ventilation was not superior to supine ventilation with respect to death in the ICU. Reference Jordi Mancebo, Rafael Fern ndez, Lluis Blanch et al. A multicenter trial of prolonged prone ventilation in severe acute respiratory distress syndrome. Am J Respir Crit Care Med. 2006 Jun 1;173(11):1233-9. Open reference URL https://web.pathway.md/studies/recwZybDWMLSyioCX 2/2