TY - JOUR T1 - Awake prone position in COVID-19 acute respiratory failure: a randomized crossover study using electrical impedance tomography JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00509-2022 SP - 00509-2022 AU - Thomas Brunelle AU - Eloi Prud'homme AU - Jean-Emmanuel Alphonsine AU - Karine Baumstarck AU - Celine Sanz AU - Saida Salmi AU - Noemie Peres AU - Jean-Marie Forel AU - Laurent Papazian AU - Sami Hraiech AU - Antoine Roch AU - Christophe Guervilly Y1 - 2023/01/01 UR - http://openres.ersjournals.com/content/early/2022/12/14/23120541.00509-2022.abstract N2 - Background The goal of this study was to determine whether an awake prone position (aPP) reduces the global inhomogeneity (GI) index of ventilation measured by electrical impedance tomography (EIT) in COVID-19 patients with acute respiratory failure (ARF).Methods This prospective crossover study included COVID-19 patients with COVID-19 and ARF defined by PaO2:FiO2 of 100–300 mmHg. After baseline evaluation and 30 min EIT recording in the supine position (SP), patients were randomized into one of two sequences: SP-aPP or aPP-SP. At the end of each 2 h step, oxygenation, respiratory rate, Borg scale, and 30 min EIT were recorded.Results Ten patients were randomized in each group. The GI index did not change in the SP-aPP group (baseline 74±20%, end of SP 78±23% and end of aPP 72±20%, p=0.85) or in the aPP-SP group (baseline 59±14%, end of aPP 59±15% and end of SP 54±13%, p=0.67). In the whole cohort, PaO2:FiO2 increased from 133±44 mmHg at baseline to 183±66 mmHg in aPP (p=0.003) and decreased to 129±49 mmHg in SP (p=0.03).Conclusion In spontaneously breathing non-intubated COVID-19 patients with acute respiratory failure, aPP was not associated with a decrease of lung ventilation inhomogeneity assessed by EIT, despite an improvement in oxygenation. ER -