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dc.contributor.authorStilma, Willemke
dc.contributor.authorÅkerman, Eva
dc.contributor.authorArtigas, Antonio
dc.contributor.authorBentley, Andrew
dc.contributor.authorBos, Lieuwe D
dc.contributor.authorBosman, Thomas J C
dc.contributor.authorde Bruin, Hendrik
dc.contributor.authorBrummaier, Tobias
dc.contributor.authorBuiteman-Kruizinga, Laura A
dc.contributor.authorCarcò, Francesco
dc.contributor.authorChesney, Gregg
dc.contributor.authorChu, Cindy
dc.contributor.authorDark, Paul
dc.contributor.authorDondorp, Arjen M
dc.contributor.authorGijsbers, Harm J H
dc.contributor.authorGilder, Mary Ellen
dc.contributor.authorGrieco, Domenico L
dc.contributor.authorInglis, Rebecca
dc.contributor.authorLaffey, John G
dc.contributor.authorLandoni, Giovanni
dc.contributor.authorLu, Weihua
dc.contributor.authorMaduro, Lisa M N
dc.contributor.authorMcGready, Rose
dc.contributor.authorMcNicholas, Bairbre
dc.contributor.authorde Mendoza, Diego
dc.contributor.authorMorales-Quinteros, Luis
dc.contributor.authorNosten, Francois
dc.contributor.authorPapali, Alfred
dc.contributor.authorPaternoster, Gianluca
dc.contributor.authorPaulus, Frederique
dc.contributor.authorPisani, Luigi
dc.contributor.authorPrud'homme, Eloi
dc.contributor.authorRicard, Jean-Damien
dc.contributor.authorRoca, Oriol
dc.contributor.authorSartini, Chiara
dc.contributor.authorScaravilli, Vittorio
dc.contributor.authorSchultz, Marcus J
dc.contributor.authorSivakorn, Chaisith
dc.contributor.authorSpronk, Peter E
dc.contributor.authorSztajnbok, Jaques
dc.contributor.authorTrigui, Youssef
dc.contributor.authorVollman, Kathleen M
dc.contributor.authorvan der Woude, Margaretha C E
dc.date.accessioned2021-05-28T18:32:24Z
dc.date.available2021-05-28T18:32:24Z
dc.date.issued2021-03-11
dc.identifier.urihttp://hdl.handle.net/10713/15849
dc.description.abstractNon-intubated patients with acute respiratory failure due to COVID-19 could benefit from awake proning. Awake proning is an attractive intervention in settings with limited resources, as it comes with no additional costs. However, awake proning remains poorly used probably because of unfamiliarity and uncertainties regarding potential benefits and practical application. To summarize evidence for benefit and to develop a set of pragmatic recommendations for awake proning in patients with COVID-19 pneumonia, focusing on settings where resources are limited, international healthcare professionals from high and low- and middle-income countries (LMICs) with known expertise in awake proning were invited to contribute expert advice. Agrowing number of observational studies describe the effects of awake proning in patients with COVID-19 pneumonia in whom hypoxemia is refractory to simple measures of supplementary oxygen. Awake proning improves oxygenation in most patients, usually within minutes, and reduces dyspnea and work of breathing. The effects are maintained for up to 1 hour after turning back to supine, and mostly disappear after 6-12 hours. In available studies, awake proning was not associated with a reduction in the rate of intubation for invasive ventilation. Awake proning comes with little complications if properly implemented and monitored. Pragmatic recommendations including indications and contraindications were formulated and adjusted for resource-limited settings. Awake proning, an adjunctive treatment for hypoxemia refractory to supplemental oxygen, seems safe in non-intubated patients with COVID-19 acute respiratory failure. We provide pragmatic recommendations including indications and contraindications for the use of awake proning in LMICs. Copyright © 2021 by The American Society of Tropical Medicine and Hygiene.en_US
dc.description.urihttps://doi.org/10.4269/ajtmh.20-1445en_US
dc.language.isoenen_US
dc.publisherAmerican Society of Tropical Medicine and Hygieneen_US
dc.relation.ispartofAmerican Journal of Tropical Medicine and Hygieneen_US
dc.subjectadjunctive therapyen_US
dc.subjectawake proningen_US
dc.subjectnon-intubated patientsen_US
dc.subject.meshCOVID-19en_US
dc.subject.meshHypoxiaen_US
dc.subject.meshRespiratory Insufficiencyen_US
dc.titleAwake Proning as an Adjunctive Therapy for Refractory Hypoxemia in Non-Intubated Patients with COVID-19 Acute Respiratory Failure: Guidance from an International Group of Healthcare Workersen_US
dc.typeArticleen_US
dc.identifier.doi10.4269/ajtmh.20-1445
dc.identifier.pmid33705348
dc.source.countryUnited States


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