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Evaluation of awake prone position on ventilation inhomogeneity in COVID-19 associated respiratory failure.
Awake prone position has been proposed as an additional treatment to alleviate hypoxemia during COVID-19 acute respiratory failure and potentially to avoid in some case tracheal intubation and invasive ventilation. Potential mechanism is improvement of ventilation: perfusion mismatch through redistribution of ventilation to the dorsal part of the lungs where perfusion is prominent. Electrical impedance tomography (EIT) is a non-invasive functional lung imaging of distribution of ventilation. Therefore, we aim to assess EIT on lung ventilation inhomogeneity during supine and prone position in COVID-19 patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| patients in prone position followed by dorsal decubitus | Other | patients will be randomized on the order of position, either supine then prone, either prone then supine. Each period will last at least 2 hours. |
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| dorsal decubitus followed by prone decubitus | Other | patients will be randomized on the order of position, either supine then prone, either prone then supine. Each period will last at least 2 hours. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| physiological effects of awake prone position in COVID 19 patients | Other | Study of physiological effects of awake prone position in COVID 19 patients on lung inhomogeneity assessed by Electrical Impedance Tomography (EIT), gas exchange and dyspnea score (Borg Scale). Measurements will be performed at baseline (on supine position), then patients will be randomized on the order of position, either supine then prone, either prone then supine. Each period will last at least 2 hours. EIT records will be performed during the last 30 minutes of each period, blood gas and dyspnea score at the end of each period. |
| Measure | Description | Time Frame |
|---|---|---|
| Global Inhomogeneity Index variations (expressed in percentage) between baseline, supine and prone position periods. | Electrical Impedance Tomography (EIT) | 2hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jean-Olivier ARNAUD | ASSISTANCE PUBLIQUE HÔPITAUX DE MARSEILLE | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Assistance Publique Höpitaux de Marseille | Marseille | 13354 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36994452 | Result | Brunelle T, Prud'homme E, Alphonsine JE, Baumstarck K, Sanz C, Salmi S, Peres N, Forel JM, Papazian L, Hraiech S, Roch A, Guervilly C. Awake prone position in COVID-19 acute respiratory failure: a randomised crossover study using electrical impedance tomography. ERJ Open Res. 2023 Mar 27;9(2):00509-2022. doi: 10.1183/23120541.00509-2022. eCollection 2023 Mar. |
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| ID | Term |
|---|---|
| D012131 | Respiratory Insufficiency |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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Each patient will be his own control. The order of the experimental periods will be:
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