Efficacy of awake prone positioning in patients with covid-19 related hypoxemic respiratory failure: systematic review and meta-analysis of randomized trials. 2/6/2023. Weatherald J. BMJ.

This is the most recent meta-analysis of awake prone positioning (APP) for COVID respiratory distress. Seventeen randomized trials involving 2,931 patients were reviewed. The results confirmed prior meta-analyses, showing that APP reduces the need for intubation with 18 being the number needed to prone to prevent an intubation. Mortality and other secondary endpoints showed no improvement or worsening with APP. The patients who seemed to benefit the most were those that tolerated longer daily periods of APP, were initially more hypoxemic, and required high flow nasal oxygen or non-invasive ventilation. 


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