Advertisement

Intensive Care Medicine

, Volume 44, Issue 1, pp 22–37 | Cite as

A prospective international observational prevalence study on prone positioning of ARDS patients: the APRONET (ARDS Prone Position Network) study

  • C. GuérinEmail author
  • P. Beuret
  • J. M. Constantin
  • G. Bellani
  • P. Garcia-Olivares
  • O. Roca
  • J. H. Meertens
  • P. Azevedo Maia
  • T. Becher
  • J. Peterson
  • A. Larsson
  • M. Gurjar
  • Z. Hajjej
  • F. Kovari
  • A. H. Assiri
  • E. Mainas
  • M. S. Hasan
  • D. R. Morocho-Tutillo
  • L. Baboi
  • J. M. Chrétien
  • G. François
  • L. Ayzac
  • L. Chen
  • L. Brochard
  • A. Mercat
  • for the investigators of the APRONET Study Group, the REVA Network, the Réseau recherche de la Société Française d’Anesthésie-Réanimation (SFAR-recherche) and the ESICM Trials Group
Original

Abstract

Introduction

While prone positioning (PP) has been shown to improve patient survival in moderate to severe acute respiratory distress syndrome (ARDS) patients, the rate of application of PP in clinical practice still appears low.

Aim

This study aimed to determine the prevalence of use of PP in ARDS patients (primary endpoint), the physiological effects of PP, and the reasons for not using it (secondary endpoints).

Methods

The APRONET study was a prospective international 1-day prevalence study performed four times in April, July, and October 2016 and January 2017. On each study day, investigators in each ICU had to screen every patient. For patients with ARDS, use of PP, gas exchange, ventilator settings and plateau pressure (Pplat) were recorded before and at the end of the PP session. Complications of PP and reasons for not using PP were also documented. Values are presented as median (1st–3rd quartiles).

Results

Over the study period, 6723 patients were screened in 141 ICUs from 20 countries (77% of the ICUs were European), of whom 735 had ARDS and were analyzed. Overall 101 ARDS patients had at least one session of PP (13.7%), with no differences among the 4 study days. The rate of PP use was 5.9% (11/187), 10.3% (41/399) and 32.9% (49/149) in mild, moderate and severe ARDS, respectively (P = 0.0001). The duration of the first PP session was 18 (16–23) hours. Measured with the patient in the supine position before and at the end of the first PP session, PaO2/FIO2 increased from 101 (76–136) to 171 (118–220) mmHg (P = 0.0001) driving pressure decreased from 14 [11–17] to 13 [10–16] cmH2O (P = 0.001), and Pplat decreased from 26 [23–29] to 25 [23–28] cmH2O (P = 0.04). The most prevalent reason for not using PP (64.3%) was that hypoxemia was not considered sufficiently severe. Complications were reported in 12 patients (11.9%) in whom PP was used (pressure sores in five, hypoxemia in two, endotracheal tube-related in two ocular in two, and a transient increase in intracranial pressure in one).

Conclusions

In conclusion, this prospective international prevalence study found that PP was used in 32.9% of patients with severe ARDS, and was associated with low complication rates, significant increase in oxygenation and a significant decrease in driving pressure.

Keywords

ARDS Prone position Mechanical ventilation Epidemiology 

Notes

Acknowledgments

The investigators of the APRONET Study Group (listed in the accompanying table of investigators), the REVA Network, the Réseau recherche de la Société Française d’Anesthésie-Réanimation (SFAR-recherche) and the ESICM Trials Group.

Table of investigators

Country

City

Name of the ICU

Name of the hospital

Collaborator #1

Collaborator #2

Head of the ICU or department

Tunisia

Tunis

Critical Care Medicine and Anesthesiology

Military hospital for instruction of Tunis

HAJJEJ Zied

SELLAMI Walid

FERJANI M

India

Lucknow

Critical Care Medicine

Sanjay Gandhi Postgraduate Institute of Medical Sciences

GURJAR Mohan

  

Saudi Arabia

Abha

Intensive care unit

Asher Central Hospital

ASSIRI Amer

AL BSHABSHE Ali

 

Saudi Arabia

Riyadh

Intensive care unit

Prince Sultan Military Medical City

ALMEKHLAFI Ghaleb

MANDOURAH Yasser

 

Malaysia

Kuala Lumpur

Intensive Care Unit

University Malaya Medical Centre

HASAN Mohd Shahnaz

RAI Vineya

MARZIDA M

Spain

Albacete

Servicio Medicina intensiva

Hospital General de Albacete

CORCOLES GONZALEZ Virgilio

SANCHEZ INIESTA Rafael

 

Spain

Madrid

Intensive Care Unit

H.G.U Gregorio Marañon

GARCIA Pablo

  

Spain

Pamplona

Intensive Care Unit

Complejo Hospitalario De Navarra

GARCIA-MONTESINOS DE LA PEÑA Manuel

GARCIA HERRERA Adriana

 

Spain

Barcelone

Vall d’Hebron—Critical Care Department

Hospital Universitari Vall d’Hebron

ROCA Oriol

GARCIA-de-ACILU Marina

 

Spain

Barcelone

Del Mar—Anestesiología y Reanimación

Hospital del Mar

MASCLANS ENVIZ Joan Ramon

  

Spain

Barcelone

San Pau—Anestesiología y Reanimación

Hospital Sant Pau

MANCEBO Jordi

  

Spain

Madrid

Unidad de Cuidados Intermedios Respiratorios

Hospital Fundación Jiménez Díaz-Quirón Salud

CALVO NATIVIDAD Arias Cesar Peset

HEILI Sarah Frades

 

Spain

Sabadell

Intensive Medicine Service

Hospital Parc Tauli

ARTIGAS RAVENTOS Antonio

BLANCH TORRA Lluís

 

Spain

Tortosa

Medicina intensiva

Hospital Verge de la Cinta

ROCHE-CAMPO Ferran

  

Spain

Palma de Mallorca

Intensive Care Department

Hospital Son Llàtzer

RIALP Gemma

FORTEZA Catalina

 

Spain

Burgos

Intensive Care Unit

Hospital Universitario de Burgos

BERRAZUETA Ana

MARTINEZ Esther

 

Spain

Getafe

Intensive Care Unit

Hospital Universitario de Getafe

PENUELAS Oscar

  

Spain

Murcia

Servicio de Medicina Intensiva

Hospital Clínico Universitario Virgen de la Arrixaca

JARA-RUBIO Ruben

  

France

Lens

Réanimation Polyvalente

Centre Hospitalier de Lens

MALLAT Jihad

 

THEVENIN D

France

Amiens

Réanimation Chirurgicale

Centre Hospitalier universitaire d’Amiens

ZOGHEIB Elie

  

France

Angers

Réanimation Médicale

Centre Hospitalier universitaire d’Angers

MERCAT Alain

  

France

Annecy

Réanimation Polyvalente

Centre Hospitalier Annecy Genevois

LEVRAT Albrice

  

France

Annonay

Réanimation Polyvalente

Centre Hospitalier Annonay

POROT Veronique

 

BEDOCK B

France

Antibes

Réanimation Polyvalente

Centre Hospitalier Antibes

GRECH Ludovic

  

France

Argenteuil

Réanimation Polyvalente

Hopital Victor Dupouy

PLANTEFEVE Gaetan

  

France

Belfort

Réanimation Polyvalente

Hopital Nord Franche Comtè

BADIE Julio

  

France

Besançon

Réanimation Chirurgicale

Centre Hospitalier Universitaire Jean Minjoz

BESCH Guillaume

PILI-FLOURY Sébastien

 

France

Bordeaux

Réanimation Médicale

Hopital Saint André

GUISSET Olivier

  

France

Bourg en Bresse

Réanimation Médicale

Centre hospitalier Bourg en Bresse

ROBINE Adrien

  

France

Brest

Réanimation Medicale

CHRU Cavale Blanche

PRAT Gwenael

  

France

Chalon sur Saone

Réanimation Médicale

Centre Hospitalier de Chalon sur Saone

DOISE Jean-Marc

  

France

Chambéry

Réanimation Polyvalente

Centre Hospitalier Metropole Savoie

BADET Michel

 

THOURET JM

France

Charleville-Mézières

Réanimation Polyvalente

Centre Hospitalier de Charleville-Mézières

JUST Bernard

  

France

Clermond -Ferrand

Réanimation Médico-Chirurgicale

Centre Hospitalier Universitaire Clermond -Ferrand

PERBET Sébastien

  

France

Clermond -Ferrand

Réanimation Médicale Polyvalente

Centre Hospitalier Universitaire Clermond -Ferrand

LAUTRETTE Alexandre

 

SOUWEINE B

France

Clermond -Ferrand

Neuro Réanimation

Centre Hospitalier Universitaire Clermond -Ferrand

CHABANNE Russell

  

France

Brest

Réanimation Polyvalente

Hôpital d’Instruction des Armées Clermont Tonnerre

DANGUY DES DÉSERTS Marc

  

France

Dieppe

Réanimation Polyvalente

Centre Hospitalier de Dieppe

RIGAUD Jean-Philippe

MARCHALOT Antoine

RIGAUD JP

France

Draguignan

Réanimation Polyvalente

Centre Hospitalier de Draguignan

BELE Nicolas

  

France

Dunkerque

Réanimation Chirurgicale

Centre Hospitalier de Dunkerque

BEAGUE Sébastien

  

France

Corbeil-Essones Cedex

Réanimation Polyvalente

Centre Hospitalier Sud Francilien

HOURS Sandrine

MARQUE Sophie

 

France

Grenoble

Réanimation Cardiovasculaire et Thoracique

Hopital Michallon

DURAND Michel

 

PAYEN JF

France

Villejuif

Réanimation USCM

Institut Gustave Roussy Cancer Campus

STOCLIN Annabelle

GAFFINEL Alain

 

France

La Réunion

Réanimation Polyvalente

Centre Hospitalier Universitaire de la Réunion

WINER Arnaud

  

France

LeMans

Réanimation Medico—Chirurgicale

Centre Hospitalier de LeMans

CHUDEAU Nicolas

TIROT Patrice

 

France

Longjumeau

Réanimation Polyvalente

Centre Hospitalier des Deux Vallées

THYRAULT Martial

PAULET Rémi

THYRAULT M

France

Lyon

Reanimation chirurgicale

Hospices Civils de Lyon, Hôpital Croix Rousse

AUBRUN Frederic

  

France

Lyon

Réanimation Médicale

Hospices Civils de Lyon, Hôpital Croix Rousse

GUERIN Claude

  

France

Lyon

Réanimation HEH Gréa

Hospices Civils de Lyon, Hôpital Edouard Herriot

FLOCCARD Bernard

 

RIMMELE T

France

Lyon

Réanimation HEH Nréa

Hospices Civils de Lyon, Hôpital Edouard Herriot

ARGAUD Laurent

HERNU Romain

 

France

Lyon

Réanimation HEH Préa

Hospices Civils de Lyon, Hôpital Edouard Herriot

CROZON CLAUZEL Jullien

  

France

Lyon

Réanimation Desgenettes

Hôpital d’instruction des armées Desgenettes

WEY Pierre-François

  

France

Lyon

Réanimation Polyvalente Saint Joseph

Centre Hospitalier Saint Joseph—Saint Luc

BOURDIN Gael

 

POMMIER C

France

Mâcon

Réanimation Médicale

Centre Hospitalier des Chanaux

CUEUILLE Nadège

 

DE VARAX

France

Marseille

Réanimation DRIS

Hopital Nord

MARCHI Elisa

 

PAPAZIAN L

France

Melun

Médecine Intensive

Centre Hospitalier de Melun

JOCHMANS Sebastien

 

MONCHI M

France

Montpellier

Réanimation Chirurgicale

Centre Hospitalier de Montpellier

JABER Samir

DE JONG Audrey

 

France

Montpellier

Réanimation Médicale

Centre Hospitalier de Montpellier

MOULAIRE Valerie

  

France

Moulins

Réanimation Polyvalente

Centre Hospitalier Moulins Yzeure

CAPRON Matthieu

 

JARRIGE L

France

Mulhouse

Réanimation Médicale

Centre Hospitalier de Mulhouse

BARBERET Guillaume

IOIDEYIN Autoine

 

France

Nantes

Réanimation chirurgicale polyvalente HGRL

de Nantes

LAKHAL Karim

 

ROZEC B

France

Nice

Réanimation Médicale

Centre Hospitalier Universitaire l’ARCHET 1

DELLAMONICA Jean

ROBERT Alexandre

BERNARDIN G

France

Nice

Réanimation Médico-Chirurgicale

Centre Hospitalier Universitaire l’ARCHET 2

DANIN Pierre-Eric

 

RAUCOULES M

France

Orleans

Réanimation Médicale

Centre Hospitalier Régional d’Orleans

RUNGE Isabelle

  

France

Paris

Réanimation Chirurgicale Polyvalente

Hôpital Beaujon (Clichy) APHP

FOUCRIER Arnaud

  

France

Paris

Réanimation Chirurgicale

Hôpital Bicêtre APHP

HAMADA Sophie

  

France

Paris

Réanimation Chirurgicale Digestive

Hôpital Cochin APHP

TESNIERE Antoine

FROMENTIN Mélanie

SAMAMA CM

France

Paris

Réanimation Médicale

Hôpital Cochin APHP

MIRA Jean-Paul

  

France

Paris

Réanimation

Hôpital George Pompidou APHP

DIEHL Jean-Luc

  

France

Créteil

Réanimation Médicale—Créteil

Hôpital Henri-Mondor APHP

MEKONTSO DESSAP Armand

  

France

Paris

Réanimation Chirurgicale

Hôpital Pitié-Salpêtrière APHP

ARBELOT Charlotte

  

France

Paris

Réanimation médicale Montyon

Hôpital Pitié-Salpêtrière APHP

DEMOULE Alexandre

ROCHE Anne

SIMILOWSKI T

France

Colombes

Réanimation Médico Chirurgicale—Louis mourier

Hopitaux Universitaires Paris Nord Val de Seine APHP

RICARD Jean-Damien

GAUDRY Stéphane

DREYFUSS D

France

Saint Denis

Réanimation Médicale—Saint Denis

Centre Hospitalier Saint Denis

de MONTMOLIN Etienne

Da SILVA Daniel

VERDIERE B

France

Paris

Réanimation Médicale—Saint Louis

Hôpital Saint Louis APHP

ARDISSON Fanny

LEMIALE Virginie

AZOULAY Elie

France

Paris

Réanimation Médicale—St joseph

Hôpital Paris Saint Joseph

BRUEL Cédric

TIERCELET Kelly

 

France

Paris

Réanimation Médico-Chirurgicale

Hôpital Tenon APHP

FARTOUKH Muriel

VOIRIOT Guillaume

 

France

Clamart

Centre de Traitement des Brûlés

Percy Military Teaching Hospital

HOFFMANN Clement

 

LECLERC T

France

Poitiers

Réanimation Médicale

Centre Hospitalier Universitaire Poitiers

THILLE Arnaud

ROBERT Réné

 

France

Roanne

Réanimation Médicale

Centre Hospitalier de Roanne

BEURET Pascal

  

France

Rouen

Réanimation Médicale

Centre Hospitalier Universitaire de Rouen

BEDUNEAU Gaëtan

BEUZELIN Marion

TAMION F

France

Saint-Priest en Jarez

Réanimation Polyvalente

Centre Hospitalier Universitaire de Saint Etienne

MOREL Jérôme

TREMBLAY Aymeric

MOLLIEX S

France

Toulon

Réanimation Polyvalente

Centre Hospitalier de Toulon

AMAL Jean-Michel

  

France

Toulon

Réanimation HIA

HIA SAINTE-ANNE

MEAUDRE Eric

GOUTORBE Philippe

 

France

Tours

Anesthésie Réanimation

Centre Hospitalier Régional Universitaire de Tours

LAFFON Marc

  

France

Le Chesnay (Versailles)

Réanimation Médico-Chirurgicale

Centre Hospitalier de Versailles

GROS Antoine

  

France

Compiegne

Réanimation

Centre Hospitalier de Compiegne Noyon

NICA Alexandru

BARJON Genevieve

 

France

Poitiers

Réanimation Chirurgicale

Centre Hospitalier Universitaire Poitiers

DAHYOT-FIZELIER Claire

IMZI Nadia

 

France

Mulhouse

Réanimation Chirurgicale

Groupe hospitalier de la région Mulhouse et sud Alsace

GALLY Josette

 

REAL

France

Cherbourg en Cotentin

Réanimation Polyvalente

Centre Hospitalier Public du Cotentin

SAUNEUF Bertrand

SOULOY Xavier

 

The Netherlands

Amsterdam

Department of Intensive Care

University Hospital VU medical centre

GIRBES Armand

TUINMAN Pieter Roel

 

The Netherlands

Amsterdam

Intensive Care Unit

Academic medical Center

SCHULTZ Marcus

WINTERS Tineke

 

The Netherlands

Roermond

Intensive Care Unit

Laurentius Ziekenhuis Roermond

MIJZEN Lisa

 

ROEKAERTS

The Netherlands

Enschede

Intensive Care Centrum

Medisch Spectrum Twente

VERMEIJDEN Wytze

BEISHUIZEN Albertus

TROF R.

The Netherlands

Nijmegen

Intensive Care afdeling

Canisius Wilhelmina Ziekenhuis

CORSTEN Stijn

  

The Netherlands

Utrecht

Department of Intensive Care Medicine

University Medical Center Utrecht

KESECIOGLU Jozef

  

The Netherlands

Groningen

Critical Care

University Medical Center Groningen

MEERTENS John

DIEPERINK Wim

 

The Netherlands

Nijmegen

Intensive Care Unit

Radboudumc

PICKERS Peter

ROOVERS Noortje

 

Portugal

Porto

Cuidados intensivos

Hospital Santo António

MAIA Paulo

DUQUE Melanie

FERNANDO RUA

Portugal

Cascais

Intensive Care

Hospital de Cascais

PEREIRA DE FIGUEIRED António Manuel

RAMOS Armindo

 

Portugal

Lisboa

Unidade de Cuidados Intensivos Respiratórios (UCIR)—Serviço de Pneumologia

Hospital de Santa Maria—Centro Hospitalar de Lisboa Norte

FRAGOSO Elsa

AZEVEDO Pilar

AZEVEDO P

Portugal

Lisboa

Serviço de Medicina Intensiva—UCIP

Hospital Santa Maria

GOUVEIA Joao

 

Zélia Costa e Silva

Portugal

Funchal

Serviço de Medicina Intensiva

Hospital Central do Funchal

SILVA Goncalo

CHAVES Susana

NOBREGA JJ

Portugal

Porto

Unidade de Cuidados Intensivos Polivalente da Urgência (UCIPU), Unidade de Cuidados Intensivos Polivalente Geral (UCIPG)

Hospital São João

LOPES Luís

NUNO Iriucipe

 

Portugal

Lisboa

 

Hospital de São Francisco Xavier

VALERIO Bernardino

  

Portugal

Amadora

 

Hospital Amadora-Sintra

ARAUJO Ana Carolina

 

Dr. Paulo Telles de Freitas

Portugal

Lisboa

 

IPO Lisboa

BOUW Maria Jose

  

Portugal

Faro

UCIP Unidade de Cuidados Intensivos Polivalente

Centro Hospitalar do Algarve

MELAO Maria

 

GRANJA C

Portugal

Gaia

 

CHVNG Centro Hospitalar Vila Nova de Gaia

MARCAL Paulo

  

Portugal

Almada

Hospital Almada

Hospital Almada

FERNANDES Antero

  

Portugal

Vila Franca Xira

Hospital Vila Franca Xira

Hospital Vila Franca Xira

JOAO Gonçalves Pereira

  

Portugal

Ponta Delgada—Açores Islands

Hospital Ponta Delgada

Hospital Ponta Delgada

FARIA MAIA Dionísio

  

Italy

Ferrara

Intensive care unit

Arcispedale Sant’Anna

SPADARO Savino

VOLTA Carlo Alberto

 

Italy

Monza

General ICU

Hospital San Gerardo

BELLANI Giacomo

 

CITERIO G

Italy

Milano

Terapia Intensiva Postoperatoria

Fondazione IRCCS Ospedale Maggiore Policlinico

MAURI Tommaso

ALBAN Laura

PESENTI A

Italy

Milano

U.O.C. Anestesia e Rianimazione

Ospedale San Paolo—Polo Universitario

MISTRALETTI Giovanni

FORMENTI Paolo

TOMMASINO C

Italy

Milano

Terapia Intensiva Generale 1

ASST Grande Ospedale Metropolitano Niguarda

TARDINI Francesca

 

FUMAGALLI R

Italy

Milano

Terapia Intensiva

Ospedale Luigi Sacco

COLOMBO Riccardo

FOSSALI Tommaso

CATENA E

Italy

Chiari

Unità di terapia intensiva

ASST FRANCIACORTA Chiari Hospital

TODESCHINI Manuel

GNESIN Paolo

 

Italy

Palermo

Terapia Intensiva Polivalente 2

ARNAS Ospedale Civico Di Cristina BENFRATELLI

CRACCHIOLO Andrea Neville

PALMA Daniela

TETAMO R

Italy

Rozzano

Terapia Intensiva Generale

Humanitas Research Hospital

ALBIERO Daniela

COSTANTINI Elena

RAIMONDI F

Italy

Lecco

Rianimazione Generale

A. Manzoni Hospital

COPPADORO Andrea

VASCOTTO Ettore

LUSENTI F

Germany

Kiel

Anesthesiology and Intensive Care Medicine

Universitätsklinik Schleswig-Holstein, Campus Kiel

BECHER Tobias

SCHÄDLER Dirk

WEILER N

Germany

Cologne

ARDS and ECMO centre Cologne

ARDS and ECMO centre Cologne-Merheim/University Witten/Herdecke

KARAGIANNIDIS Christian

  

Sweden

Stockholm

Karolinska Universitetssjukhuset, Solna

Karolinska University Hospital Solna

PETERSSON Johan

 

KONRAD D

Sweden

Uppsala

Central intensive care

Akademiska sjukhuset

KAWATI Rafael

WESSBERGH Joanna

VALTYSSON J

Sweden

Kalmar

ICU

Länssjukhuset i Kalmar

ROCKSTROH Matthias

BORGSTROM Sten

 

Sweden

Umeå

Centrum för intensiv och postoperativ vård

Umeå University Hospital

LARSSON Niklas

 

THUNBERG J

UK

Poole

Critical Care Unit

Poole Hospital

CAMSOOKSAI Julie

 

BRIGGS

UK

London

Critical care complex

The North Middlesex University Hospital Trust

KOVARI Ferenc

 

CUESTA J

UK

London

Barts Heart Centre

Barts Heart Centre- St. Bartholomew’s Hospital

ANWAR Sibs

 

O’ BRIEN B

UK

Carlisle

Intensive Care

Cumberland Infirmary

BARBERIS Luigi

 

STURMAN J

Greece

Athens

Intensive Care Unit

Hippokrateion General Hospital of Athens

MAINAS Efstratios

 

KARATZAS S

Czech Republic

Prague

Intensive Care Unit

IKEM Institute of Clinical and Experimental Medicine

PIZA Petr

  

Belgium

Gosselies

Intensive Care Unit

Clinique Notre-Dame de Grâce

SOTTIAUX Thierry

 

ADAM JF

Poland

Opole

Department of Anesthesiology and Critical Care

PS ZOZ Wojewodzkie Centrum Medyczne w Opolu

GAWDA Ryszard

 

GAWOR M

Canada

Moncton

Respirology Critical Care

The Moncton Hospital

ALQDAH Maen

 

ALQDAH M and COHEN D

Canada

Toronto

Intensive Care Unit

St. Michael’s Hospital

BROCHARD Laurent

 

BAKER A

Mexico

Mexico City

Department of Critical Care Unit

Instituto Nacional de Cancerología

ÑAMENDYS-SILVA Silvio Antonio

GARCIA-GUILLEN Francisco Javier

 

Ecuador

Quito

Unidad de Terapia Intensiva

Hospital de Especialidades Eugenio Espejo

MOROCHO TUTILLO Diego Rolando

JIBAJA VEGA Manuel

JIBAJA VEGA MANUEL

Argentina

Mendoza

Terapia intensiva

Hospital Luis Carlos Lagomaggiore

ZAKALIK Graciela

PAGELLA Gonzalo

MARENGO J

Compliance with ethical standards

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

134_2017_4996_MOESM1_ESM.pdf (196 kb)
Supplementary material 1 (PDF 195 kb) Electronic case record form used in the APRONET study. Fig. 2 Prevalence of prone position use in each study period (upper panel) and across ARDS categories over all study periods (lower panel)
134_2017_4996_MOESM2_ESM.pptx (50 kb)
Supplementary material 2 (PPTX 50 kb)
134_2017_4996_MOESM3_ESM.docx (15 kb)
Supplementary material 3 (DOCX 14 kb)
134_2017_4996_MOESM4_ESM.docx (16 kb)
Supplementary material 4 (DOCX 15 kb)
134_2017_4996_MOESM5_ESM.docx (14 kb)
Supplementary material 5 (DOCX 14 kb)
134_2017_4996_MOESM6_ESM.docx (16 kb)
Supplementary material 6 (DOCX 15 kb)
134_2017_4996_MOESM7_ESM.docx (16 kb)
Supplementary material 7 (DOCX 15 kb)
134_2017_4996_MOESM8_ESM.docx (15 kb)
Supplementary material 8 (DOCX 15 kb)
134_2017_4996_MOESM9_ESM.docx (15 kb)
Supplementary material 9 (DOCX 15 kb)
134_2017_4996_MOESM10_ESM.xlsx (29 kb)
Supplementary material 10 (XLSX 29 kb)

References

  1. 1.
    Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, Gattinoni L, van Haren F, Larsson A, McAuley DF, Ranieri M, Rubenfeld G, Thompson BT, Wrigge H, Slutsky AS, Pesenti A (2016) Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA 315:788–800CrossRefPubMedGoogle Scholar
  2. 2.
    Tonelli AR, Zein J, Adams J, Ioannidis JP (2014) Effects of interventions on survival in acute respiratory distress syndrome: an umbrella review of 159 published randomized trials and 29 meta-analyses. Intensive Care Med 40:769–787CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    ARDSnet (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med 342:1301–1308CrossRefGoogle Scholar
  4. 4.
    Papazian L, Forel JM, Gacouin A, Penot-Ragon C, Perrin G, Loundou A, Jaber S, Arnal JM, Perez D, Seghboyan JM, Constantin JM, Courant P, Lefrant JY, Guerin C, Prat G, Morange S, Roch A (2010) Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 363:1107–1116CrossRefPubMedGoogle Scholar
  5. 5.
    Guerin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T, Mercier E, Badet M, Mercat A, Baudin O, Clavel M, Chatellier D, Jaber S, Rosselli S, Mancebo J, Sirodot M, Hilbert G, Bengler C, Richecoeur J, Gainnier M, Bayle F, Bourdin G, Leray V, Girard R, Baboi L, Ayzac L, Group PS (2013) Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 368:2159–2168CrossRefPubMedGoogle Scholar
  6. 6.
    Gattinoni L, Carlesso E, Taccone P, Polli F, Guerin C, Mancebo J (2010) Prone positioning improves survival in severe ARDS: a pathophysiologic review and individual patient meta-analysis. Minerva Anestesiol 76:448–454PubMedGoogle Scholar
  7. 7.
    Guérin C, Beuret P, Constantin JM, Bellani G, Baboi L, Mercat A, Chrétien JM, François G (2017) A prospective international observational one-day prevalence study on prone positioning in ARDS. The APRONET study. Intensive Care Med Exp 5:44CrossRefGoogle Scholar
  8. 8.
    Ranieri VM, Rubenfeld GD, Thompson BT, Fergsuon ND, Cladwell E, Fan E, Camporota L, Slutsky AS (2012) Acute Respiratory Distress Syndrome. The Berlin definition. JAMA 307:E1–E8Google Scholar
  9. 9.
    Esteban A, Anzueto A, Frutos F, Alia I, Brochard L, Stewart TE, Benito S, Epstein SK, Apezteguia C, Nightingale P, Arroliga AC, Tobin MJ (2002) Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA 287:345–355CrossRefPubMedGoogle Scholar
  10. 10.
    Esteban A, Ferguson ND, Meade MO, Frutos-Vivar F, Apezteguia C, Brochard L, Raymondos K, Nin N, Hurtado J, Tomicic V, Gonzalez M, Elizalde J, Nightingale P, Abroug F, Pelosi P, Arabi Y, Moreno R, Jibaja M, D’Empaire G, Sandi F, Matamis D, Montanez AM, Anzueto A (2008) Evolution of mechanical ventilation in response to clinical research. Am J Respir Crit Care Med 177:170–177CrossRefPubMedGoogle Scholar
  11. 11.
    Gattinoni L, Tognoni G, Pesenti A, Taccone P, Mascheroni D, Labarta V, Malacrida R, Di Giulio P, Fumagalli R, Pelosi P, Brazzi L, Latini R (2001) Effect of prone positioning on the survival of patients with acute respiratory failure. N Engl J Med 345:568–573CrossRefPubMedGoogle Scholar
  12. 12.
    Guerin C, Gaillard S, Lemasson S, Ayzac L, Girard R, Beuret P, Palmier B, Le QV, Sirodot M, Rosselli S, Cadiergue V, Sainty J-M, Barbe P, Combourieu E, Debatty D, Rouffineau J, Ezingeard E, Millet O, Guelon D, Rodriguez L, Martin O, Renault A, Sibille J-P, Kaidomar M (2004) Effects of systematic prone positioning in hypoxemic acute respiratory failure: a randomized controlled trial. JAMA 292:2379–2387CrossRefPubMedGoogle Scholar
  13. 13.
    Mancebo J, Fernandez R, Blanch L, Rialp G, Gordo F, Ferrer M, Rodriguez F, Garro P, Ricart P, Vallverdu I, Gich I, Castano J, Saura P, Dominguez G, Bonet A, Albert RK (2006) A multicenter trial of prolonged prone ventilation in severe acute respiratory distress syndrome. Am J Respir Crit Care Med 173:1233–1239CrossRefPubMedGoogle Scholar
  14. 14.
    Taccone P, Pesenti A, Latini R, Polli F, Vagginelli F, Mietto C, Caspani L, Raimondi F, Bordone G, Iapichino G, Mancebo J, Guerin C, Ayzac L, Blanch L, Fumagalli R, Tognoni G, Gattinoni L (2009) Prone positioning in patients with moderate and severe acute respiratory distress syndrome: a randomized controlled trial. JAMA 302:1977–1984CrossRefPubMedGoogle Scholar
  15. 15.
    Esteban A, Frutos-Vivar F, Muriel A, Ferguson ND, Penuelas O, Abraira V, Raymondos K, Rios F, Nin N, Apezteguia C, Violi DA, Thille AW, Brochard L, Gonzalez M, Villagomez AJ, Hurtado J, Davies AR, Du B, Maggiore SM, Pelosi P, Soto L, Tomicic V, D’Empaire G, Matamis D, Abroug F, Moreno RP, Soares MA, Arabi Y, Sandi F, Jibaja M, Amin P, Koh Y, Kuiper MA, Bulow HH, Zeggwagh AA, Anzueto A (2013) Evolution of mortality over time in patients receiving mechanical ventilation. Am J Respir Crit Care Med 188:220–230CrossRefPubMedGoogle Scholar
  16. 16.
    Laffey JG, Kavanagh BP (2017) Fifty years of research in ARDS. Insight into Acute Respiratory Distress Syndrome. From models to patients. Am J Respir Crit Care Med 196:18–28CrossRefPubMedGoogle Scholar
  17. 17.
    Sud S, Friedrich JO, Taccone P, Polli F, Adhikari NK, Latini R, Pesenti A, Guerin C, Mancebo J, Curley MA, Fernandez R, Chan MC, Beuret P, Voggenreiter G, Sud M, Tognoni G, Gattinoni L (2010) Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis. Intensive Care Med 36:585–599CrossRefPubMedGoogle Scholar
  18. 18.
    Sud S, Friedrich JO, Adhikari NK, Taccone P, Mancebo J, Polli F, Latini R, Pesenti A, Curley MA, Fernandez R, Chan MC, Beuret P, Voggenreiter G, Sud M, Tognoni G, Gattinoni L, Guerin C (2014) Effect of prone positioning during mechanical ventilation on mortality among patients with acute respiratory distress syndrome: a systematic review and meta-analysis. CMAJ 186:E381–E390CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Lee JM, Bae W, Lee YJ, Cho YJ (2014) The efficacy and safety of prone positional ventilation in acute respiratory distress syndrome: updated study-level meta-analysis of 11 randomized controlled trials. Crit Care Med 42:1252–1262CrossRefPubMedGoogle Scholar
  20. 20.
    Broccard A, Shapiro RS, Schmitz LL, Adams AB, Nahum A, Marini JJ (2000) Prone positioning attenuates and redistributes ventilator-induced lung injury in dogs. Crit Care Med 28:295–303CrossRefPubMedGoogle Scholar
  21. 21.
    Jozwiak M, Teboul JL, Monnet X (2014) Reply: prone positioning actually exerts benefits on hemodynamics! Am J Respir Crit Care Med 189:1567–1568CrossRefPubMedGoogle Scholar
  22. 22.
    Cressoni M, Cadringher P, Chiurazzi C, Amini M, Gallazzi E, Marino A, Brioni M, Carlesso E, Chiumello D, Quintel M, Bugedo G, Gattinoni L (2014) Lung inhomogeneity in patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 189:149–158PubMedGoogle Scholar
  23. 23.
    Jaber S, Bellani G, Blanch L, Demoule A, Esteban A, Gattinoni L, Guerin C, Hill N, Laffey JG, Maggiore SM, Mancebo J, Mayo PH, Mosier JM, Navalesi P, Quintel M, Vincent JL, Marini JJ (2017) The intensive care medicine research agenda for airways, invasive and noninvasive mechanical ventilation. Intensive Care Med.  https://doi.org/10.1007/s00134-017-4896-8 Google Scholar
  24. 24.
    Jozwiak M, Teboul JL, Anguel N, Persichini R, Silva S, Chemla D, Richard C, Monnet X (2013) Beneficial hemodynamic effects of prone positioning in patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 188:1428–1433CrossRefPubMedGoogle Scholar
  25. 25.
    De Jong A, Molinari N, Sebbane M, Prades A, Futier E, Jung B, Chanques G, Jaber S (2013) Feasibility and effectiveness of prone position in morbidly obese patients with ARDS: a case-control clinical study. Chest 143:1554–1561CrossRefPubMedGoogle Scholar
  26. 26.
    Puybasset L, Cluzel P, Gusman P, Grenier P, Preteux F, Rouby JJ (2000) Regional distribution of gas and tissue in acute respiratory distress syndrome. I. Consequences for lung morphology. CT Scan ARDS Study Group. Intensive Care Med 26:857–869CrossRefPubMedGoogle Scholar
  27. 27.
    Gaudry S, Tuffet S, Lukaszewicz AC, Laplace C, Zucman N, Pocard M, Costaglioli B, Msika S, Duranteau J, Payen D, Dreyfuss D, Hajage D, Ricard JD (2017) Prone positioning in acute respiratory distress syndrome after abdominal surgery: a multicenter retrospective study: SAPRONADONF (Study of Ards and PRONe position After abDOmiNal surgery in France). Ann Intensive Care 7:21CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Amato MB, Meade MO, Slutsky AS, Brochard L, Costa EL, Schoenfeld DA, Stewart TE, Briel M, Talmor D, Mercat A, Richard JC, Carvalho CR, Brower RG (2015) Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 372:747–755CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature and ESICM 2017

Authors and Affiliations

  • C. Guérin
    • 1
    • 2
    • 3
    • 30
    Email author
  • P. Beuret
    • 4
  • J. M. Constantin
    • 5
    • 6
  • G. Bellani
    • 7
  • P. Garcia-Olivares
    • 8
  • O. Roca
    • 9
    • 10
  • J. H. Meertens
    • 11
  • P. Azevedo Maia
    • 12
  • T. Becher
    • 13
  • J. Peterson
    • 14
    • 15
  • A. Larsson
    • 16
    • 17
  • M. Gurjar
    • 17
  • Z. Hajjej
    • 18
  • F. Kovari
    • 19
  • A. H. Assiri
    • 20
  • E. Mainas
    • 21
  • M. S. Hasan
    • 22
  • D. R. Morocho-Tutillo
    • 23
  • L. Baboi
    • 1
  • J. M. Chrétien
    • 24
  • G. François
    • 25
  • L. Ayzac
    • 26
  • L. Chen
    • 27
  • L. Brochard
    • 27
  • A. Mercat
    • 28
    • 29
  • for the investigators of the APRONET Study Group, the REVA Network, the Réseau recherche de la Société Française d’Anesthésie-Réanimation (SFAR-recherche) and the ESICM Trials Group
  1. 1.Réanimation Médicale Hôpital de la Croix Rousse, Hospices Civils de LyonLyonFrance
  2. 2.Université de LyonLyonFrance
  3. 3.IMRB INSERM 955 CréteilCréteilFrance
  4. 4.Réanimation polyvalente RoanneRoanneFrance
  5. 5.Department of Preoperative MedicineUniversity Hospital of Clermont-FerrandClermont-FerrandFrance
  6. 6.Faculté de médecine, GReD, UMR,CNRS6293, UCA, INSERM, U1103 R2D2 EA-7281Université d’AuvergneClermont-FerrandFrance
  7. 7.Dipartimento di Medicina e Chirurgia MonzaUniversità degli Studi Milano BicoccaMilanItaly
  8. 8.Intensive Care UnitH.G.U Gregorio MarañónMadridSpain
  9. 9.Critical Care DepartmentVall d’Hebron University Hospital, Vall d’Hebron Research InstituteBarcelonaSpain
  10. 10.Ciber Enfermedades Respiratorias (Ciberes), Instituto de Salud Carlos IIIMadridSpain
  11. 11.Department of Critical CareUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
  12. 12.Cuidados intensivos-Centro Hospitalar do PortoPortoPortugal
  13. 13.Universitätsklinikum Schleswig-HolsteinKielGermany
  14. 14.Function Perioperative Medicine and Intensive CareKarolinska University Hospital SolnaStockholmSweden
  15. 15.Department of Physiology and Pharmacology, Section of Anesthesiology and Intensive Care MedicineKarolinska InstitutetStockholmSweden
  16. 16.Hedenstierna Laboratory, Department of Surgical SciencesUppsala UniversityUppsalaSweden
  17. 17.Department of Critical Care MedicineSanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia
  18. 18.Department of Critical Care Medicine and AnesthesiologyMilitary Hospital of TunisTunisTunisia
  19. 19.The North Middlesex University Hospital TrustLondonUK
  20. 20.Aseer Central HospitalAbhaSaudi Arabia
  21. 21.Hippokrateion General Hospital of AthensAthensGreece
  22. 22.University Malaya Medical CentreKuala LumpurMalaysia
  23. 23.Unidad de Terapia Intensiva Hospital de Especialidades Eugenio EspejoQuitoEcuador
  24. 24.CHU Angers-DRCi-Cellule Gestion des Données et EvaluationAngersFrance
  25. 25.Division of Scientific Affairs–Research, ESICMBrusselsBelgium
  26. 26.Centre de coordination et de lutte contre les infections nosocomiales (C-CLIN) Sud-EstPierre BéniteFrance
  27. 27.Saint Michael’s HospitalTorontoCanada
  28. 28.Médecine Intensive et Réanimation, CHU AngersAngersFrance
  29. 29.Université d’AngersAngersFrance
  30. 30.INSERMCreteilFrance

Personalised recommendations