CoV-APP [COVID-19]
Research type
Research Study
Full title
COVID-19: Awake Prone Positioning: A Retrospective Case Series Design
IRAS ID
283180
Contact name
Raha West
Contact email
Sponsor organisation
Buckinghamshire NHS Trust
Duration of Study in the UK
0 years, 3 months, 1 days
Research summary
Awake prone positioning (lying facing the chest down) may slow respiratory deterioration and improve clinical outcomes for patients with COVID-19. This simple, low-cost intervention has the potential to reduce demand on oxygen consumption, ventilator use and ease the strain placed on healthcare systems. These are based on well-documented physiological principles. Currently, our knowledge about prone positioning is extrapolated from studies in non-awake, mechanically ventilated patients. In the absence of robust clinical evidence, these proposed benefits remain theoretical. \n \nFollowing the recent Intensive Care Society guideline, Buckinghamshire NHS Trust has implemented awake prone positioning to become the standard of care in suspected or confirmed COVID-19 patients since April 2020. These provide a unique opportunity to investigate the possible benefit of this intervention further. \n\nOur objectives are to measure and compare outcomes in both cohorts before and following the implementation of awake prone positioning as the early intervention in COVID-19 patients. We will use a retrospective case series design of 300 patients in each cohort. Patients included in the study are all awake, inpatients aged >18years with clinically suspected or confirmed COVID-19 and hypoxic respiratory failure requiring hospitalisation. \n\nThis research is limited to secondary use of information previously collected in the course of routine care (without an intention to use it for research at the time of collection). Data will be collected by the direct clinical care team. The outcome measures include all-cause 28 days mortality, oxygen consumption, the requirement for invasive mechanical ventilation, and the length of hospital stay.\n\nAs this is a retrospective study, there are no immediate benefits for patients within the study. However, now is the time to collect pragmatic, reliable evidence about the safety and efficacy of awake prone positioning. The information may help us to overcome the current pandemic and will be better prepared for future ones.\n
REC name
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REC reference
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