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Awake prone positioning and oxygen therapy in patients with COVID-19: the APRONOX study - PMC
Source: ncbi.nlm.nih.gov
Article summary:
1. The APRONOX study evaluated the effects of awake prone positioning and oxygen therapy in patients with COVID-19.
2. The study found that awake prone positioning was associated with a lower risk of intubation and mortality compared to awake supine positioning.
3. Factors associated with intubation among awake prone patients included increasing age, lower baseline PaO2/FIO2 ratio, and management with a nonrebreather mask.
Article analysis:
The article is generally trustworthy and reliable, as it is based on a multicentre observational study conducted between 1 May 2020 and 12 June 2020 in 27 hospitals in Mexico and Ecuador. The authors have used logistic regression models, multivariable and centre adjustment, propensity score analyses, and E-values to limit confounding. Furthermore, the article provides detailed information about the methods used in the study as well as the results obtained from it.
However, there are some potential biases that should be noted. Firstly, the study is retrospective in nature which means that there may be some recall bias present due to participants not being able to accurately remember their experiences or data from past events. Secondly, since this is an observational study rather than a randomized controlled trial (RCT), it is possible that there are other factors at play which could influence the results such as differences in patient characteristics or treatment protocols between hospitals or countries which were not accounted for in the analysis. Finally, since this was a relatively short-term study (1 month) it is possible that longer-term effects of awake prone positioning were not taken into consideration which could lead to different conclusions being drawn from the data presented here.
In conclusion, while this article provides useful insights into the effects of awake prone positioning on intubation rates and mortality among COVID-19 patients, further research should be conducted using RCTs to confirm these findings over longer periods of time and account for any potential biases present in this observational study.