Analysis of influencing factors of the awake prone position in patients with mild and moderate acute respiratory distress syndrome_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LIAO Shunqi , YUE Yan , ZHOU Xiujuan , XIANG Mengling ,  GAO Peiyang

Department of Critical Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610000, P. R. China;

Corresponding author：

GAO Peiyang, Email: gaopy930@126.com

Keywords：

Acute respiratory distress syndrome; prone position; awake prone position; impact factor

DOI：

10.7507/1671-6205.202303019

Video：

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Objective To investigate the current status and influencing factors of the awake prone position in patients with mild and moderate acute respiratory distress syndrome (ARDS). Methods A total of 210 patients with mild to moderate ARDS admitted between December 2022 and January 2023 were investigated by general information questionnaire and self-made prone position knowledge questionnaire. The daily prone position time during hospitalization was recorded. The influencing factors of awake prone position were analyzed by univariate and multivariate linear regression. Results The 210 mild and moderate ARDS patients had an average daily prone position length of stay of (4.97±3.94)h/d, showing a low level. Multiple linear regression analysis showed that prone position knowledge score, age, waist circumference and BMI were the influencing factors of awake prone position (P<0.05). Conclusions Daily awake prone position length was at a low level in mild and moderate ARDS patients. Healthcare workers can prolong the time in the prone position by developing an individualized treatment plan for the prone position, improving the patient’s perception of the prone position, and resolving the discomfort from the prone position.

Citation： LIAO Shunqi, YUE Yan, ZHOU Xiujuan, XIANG Mengling, GAO Peiyang. Analysis of influencing factors of the awake prone position in patients with mild and moderate acute respiratory distress syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(12): 873-877. doi: 10.7507/1671-6205.202303019 Copy

1.	Meyer NJ, Gattinoni L, Calfee CS. Acute respiratory distress syndrome. Lancet, 2021, 398(10300): 622-637.
2.	Ehrmann S, Li J, Ibarra-Estrada M, et al. Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: a randomised, controlled, multinational, open-label meta-trial. Lancet Respir Med, 2021, 9(12): 1387-1395.
3.	Lucchini A, Russotto V, Barreca N, et al. Short and long-term complications due to standard and extended prone position cycles in COViD-19 patients. Intensive Crit Care Nurs, 2022, 69: 103158.
4.	Fazzini B, Page A, Pearse R, et al. Prone positioning for non-intubated spontaneously breathing patients with acute hypoxaemic respiratory failure: a systematic review and meta-analysis. Br J Anaesth, 2022, 128(2): 352-362.
5.	张勤芹, 唐诚, 缪翠维, 等. 早期清醒俯卧位联合经鼻高流量氧疗对轻中度ARDS患者的研究. 临床肺科杂志, 2022, 27(6): 858-861.
6.	岳伟岗, 张莹, 蒋由飞, 等. 俯卧位通气对急性呼吸窘迫综合征患者的影响. 中国呼吸与危重监护杂志, 2019, 18(6): 532-536.
7.	Jayakumar D, Ramachandran Dnb P, Rabindrarajan Dnb E, et al. Standard care versus awake prone position in adult nonintubated patients with acute hypoxemic respiratory failure secondary to COVID-19 infection--a multicenter feasibility randomized controlled trial. J Intensive Care Med, 2021, 36(8): 918-924.
8.	漆敏, 倪忠, 唐永江, 等. 清醒俯卧位通气策略在低氧性呼吸衰竭患者中的应用进展. 中国呼吸与危重监护杂志, 2021, 20(3): 215-218.
9.	王志勇, 冯全胜, 于洪志, 等. 清醒俯卧位治疗用于奥密克戎变异株所致普通型新冠肺炎的临床研究. 中华危重病急救医学, 2022, 34(6): 576-580.
10.	ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA, 2012, 307(23): 2526-2533.
11.	蒋燕, 陆叶, 蒋旭琴, 等. 成人急性呼吸窘迫综合征患者俯卧位通气管理的最佳证据总结. 中华护理杂志, 2022, 57(15): 1878-1885.
12.	Qian ET, Gatto CL, Amusina O, et al. Assessment of awake prone positioning in hospitalized adults with COVID-19: a nonrandomized controlled trial. JAMA Intern Med, 2022, 182(6): 612-621.
13.	段均. 急性呼吸窘迫综合征患者机械通气指南(试行)解读. 重庆医科大学学报, 2017, 42(1): 76-78.
14.	Fan E, Del Sorbo L, Goligher E C, et al. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome. Am J Respir CritCare Med, 2017, 195(9): 1253-1263.
15.	郝培育, 李秋萍. ICU护士俯卧位通气知信行现状及影响因素分析. 护理学杂志, 2022, 37(20): 84-86.
16.	Poor AD, Acquah SO, Wells CM, et al. Implementing automated prone ventilation for acute respiratory distress syndrome via simulation-based training. Am Crit Care, 2020, 29(3): e52-e59.
17.	赵小莉, 刘学勤. TDP照射和香薰理疗对提高视网膜脱离术后俯卧位患者舒适度的效果评价. 当代护士(下旬刊), 2016(12): 1-3.
18.	Alhazzani W, Parhar KKS, Weatherald J, et al. Effect of awake prone positioning on endotracheal intubation in patients with COVID-19 and acute respiratory failure: a randomized clinical trial. JAMA, 2022, 327(21): 2104-2113.
19.	朱鸿丹. AECOPD合并肺栓塞的临床特征及与BMI的关系研究. 昆明医科大学, 2022.
20.	Li J, Luo J, Pavlov I, et al. Awake prone positioning for non-intubated patients with COVID-19-related acute hypoxaemic respiratory failure: a systematic review and meta-analysis. Lancet Respir Med, 2022, 10(6): 573-583.
21.	Carsetti A, Damia Paciarini A, Marini B, et al. Prolonged prone position ventilation for SARS-CoV-2 patients is feasible and effective. Crit Care, 2020, 24(1): 225.
22.	Cornejo RA, Montoya J, Gajardo AIJ, et al. Continuous prolonged prone positioning in COVID-19-related ARDS: a multicenter cohort study from Chile. Ann Intensive Care, 2022, 12(1): 109.
23.	张雨, 刘芳丽, 高孟娟, 等. 痴呆病人居家照顾者心理灵活性现状及影响因素. 护理研究, 2022, 36(23): 4287-4291.
24.	王琛. 优势内容递增教育法对乳腺癌化疗患者癌因性疲乏的影响. 武汉轻工大学, 2023.
25.	孔娜. 老年社会工作的伦理困境及应对原则. 伦理学研究, 2015(2): 123-126.
26.	岳伟岗. 俯卧位通气对急性呼吸窘迫综合征患者的Meta分析及临床研究. 兰州大学, 2018.

1. Meyer NJ, Gattinoni L, Calfee CS. Acute respiratory distress syndrome. Lancet, 2021, 398(10300): 622-637.
2. Ehrmann S, Li J, Ibarra-Estrada M, et al. Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: a randomised, controlled, multinational, open-label meta-trial. Lancet Respir Med, 2021, 9(12): 1387-1395.
3. Lucchini A, Russotto V, Barreca N, et al. Short and long-term complications due to standard and extended prone position cycles in COViD-19 patients. Intensive Crit Care Nurs, 2022, 69: 103158.
4. Fazzini B, Page A, Pearse R, et al. Prone positioning for non-intubated spontaneously breathing patients with acute hypoxaemic respiratory failure: a systematic review and meta-analysis. Br J Anaesth, 2022, 128(2): 352-362.
5. 张勤芹, 唐诚, 缪翠维, 等. 早期清醒俯卧位联合经鼻高流量氧疗对轻中度ARDS患者的研究. 临床肺科杂志, 2022, 27(6): 858-861.
6. 岳伟岗, 张莹, 蒋由飞, 等. 俯卧位通气对急性呼吸窘迫综合征患者的影响. 中国呼吸与危重监护杂志, 2019, 18(6): 532-536.
7. Jayakumar D, Ramachandran Dnb P, Rabindrarajan Dnb E, et al. Standard care versus awake prone position in adult nonintubated patients with acute hypoxemic respiratory failure secondary to COVID-19 infection--a multicenter feasibility randomized controlled trial. J Intensive Care Med, 2021, 36(8): 918-924.
8. 漆敏, 倪忠, 唐永江, 等. 清醒俯卧位通气策略在低氧性呼吸衰竭患者中的应用进展. 中国呼吸与危重监护杂志, 2021, 20(3): 215-218.
9. 王志勇, 冯全胜, 于洪志, 等. 清醒俯卧位治疗用于奥密克戎变异株所致普通型新冠肺炎的临床研究. 中华危重病急救医学, 2022, 34(6): 576-580.
10. ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA, 2012, 307(23): 2526-2533.
11. 蒋燕, 陆叶, 蒋旭琴, 等. 成人急性呼吸窘迫综合征患者俯卧位通气管理的最佳证据总结. 中华护理杂志, 2022, 57(15): 1878-1885.
12. Qian ET, Gatto CL, Amusina O, et al. Assessment of awake prone positioning in hospitalized adults with COVID-19: a nonrandomized controlled trial. JAMA Intern Med, 2022, 182(6): 612-621.
13. 段均. 急性呼吸窘迫综合征患者机械通气指南(试行)解读. 重庆医科大学学报, 2017, 42(1): 76-78.
14. Fan E, Del Sorbo L, Goligher E C, et al. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome. Am J Respir CritCare Med, 2017, 195(9): 1253-1263.
15. 郝培育, 李秋萍. ICU护士俯卧位通气知信行现状及影响因素分析. 护理学杂志, 2022, 37(20): 84-86.
16. Poor AD, Acquah SO, Wells CM, et al. Implementing automated prone ventilation for acute respiratory distress syndrome via simulation-based training. Am Crit Care, 2020, 29(3): e52-e59.
17. 赵小莉, 刘学勤. TDP照射和香薰理疗对提高视网膜脱离术后俯卧位患者舒适度的效果评价. 当代护士(下旬刊), 2016(12): 1-3.
18. Alhazzani W, Parhar KKS, Weatherald J, et al. Effect of awake prone positioning on endotracheal intubation in patients with COVID-19 and acute respiratory failure: a randomized clinical trial. JAMA, 2022, 327(21): 2104-2113.
19. 朱鸿丹. AECOPD合并肺栓塞的临床特征及与BMI的关系研究. 昆明医科大学, 2022.
20. Li J, Luo J, Pavlov I, et al. Awake prone positioning for non-intubated patients with COVID-19-related acute hypoxaemic respiratory failure: a systematic review and meta-analysis. Lancet Respir Med, 2022, 10(6): 573-583.
21. Carsetti A, Damia Paciarini A, Marini B, et al. Prolonged prone position ventilation for SARS-CoV-2 patients is feasible and effective. Crit Care, 2020, 24(1): 225.
22. Cornejo RA, Montoya J, Gajardo AIJ, et al. Continuous prolonged prone positioning in COVID-19-related ARDS: a multicenter cohort study from Chile. Ann Intensive Care, 2022, 12(1): 109.
23. 张雨, 刘芳丽, 高孟娟, 等. 痴呆病人居家照顾者心理灵活性现状及影响因素. 护理研究, 2022, 36(23): 4287-4291.
24. 王琛. 优势内容递增教育法对乳腺癌化疗患者癌因性疲乏的影响. 武汉轻工大学, 2023.
25. 孔娜. 老年社会工作的伦理困境及应对原则. 伦理学研究, 2015(2): 123-126.
26. 岳伟岗. 俯卧位通气对急性呼吸窘迫综合征患者的Meta分析及临床研究. 兰州大学, 2018.

Chinese Journal of Respiratory and Critical Care Medicine

Analysis of influencing factors of the awake prone position in patients with mild and moderate acute respiratory distress syndrome

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