Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis

Background Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between...
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Autor*in:	Giani, Marco [verfasserIn] Rezoagli, Emanuele Guervilly, Christophe Rilinger, Jonathan Duburcq, Thibault Petit, Matthieu Textoris, Laura Garcia, Bruno Wengenmayer, Tobias Grasselli, Giacomo Pesenti, Antonio Combes, Alain Foti, Giuseppe Schmidt, Matthieu

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	Acute respiratory distress syndrome Extracorporeal membrane oxygenation Prone positioning Pooled data analysis Mortality

Anmerkung:	© The Author(s) 2022

Übergeordnetes Werk:	Enthalten in: Critical care - London : BioMed Central, 1997, 26(2022), 1 vom: 06. Jan.
Übergeordnetes Werk:	volume:26 ; year:2022 ; number:1 ; day:06 ; month:01

Links:	Volltext

DOI / URN:	10.1186/s13054-021-03879-w

Katalog-ID:	SPR050340573

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520			\|a Background Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies. Methods We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to “conventional” ECMO management (Supine group) in patients with severe ARDS. Results 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42–1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072). Conclusions In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. The impact of this procedure will have to be definitively assessed by prospective randomized controlled trials.
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allfields	10.1186/s13054-021-03879-w doi (DE-627)SPR050340573 (SPR)s13054-021-03879-w-e DE-627 ger DE-627 rakwb eng Giani, Marco verfasserin (orcid)0000-0001-8048-2721 aut Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies. Methods We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to “conventional” ECMO management (Supine group) in patients with severe ARDS. Results 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42–1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072). Conclusions In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. The impact of this procedure will have to be definitively assessed by prospective randomized controlled trials. Acute respiratory distress syndrome (dpeaa)DE-He213 Extracorporeal membrane oxygenation (dpeaa)DE-He213 Prone positioning (dpeaa)DE-He213 Pooled data analysis (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 Rezoagli, Emanuele (orcid)0000-0002-4506-7212 aut Guervilly, Christophe (orcid)0000-0001-9066-6591 aut Rilinger, Jonathan (orcid)0000-0001-9333-3629 aut Duburcq, Thibault aut Petit, Matthieu aut Textoris, Laura aut Garcia, Bruno aut Wengenmayer, Tobias aut Grasselli, Giacomo aut Pesenti, Antonio aut Combes, Alain aut Foti, Giuseppe aut Schmidt, Matthieu aut Enthalten in Critical care London : BioMed Central, 1997 26(2022), 1 vom: 06. Jan. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:26 year:2022 number:1 day:06 month:01 https://dx.doi.org/10.1186/s13054-021-03879-w kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 26 2022 1 06 01
spelling	10.1186/s13054-021-03879-w doi (DE-627)SPR050340573 (SPR)s13054-021-03879-w-e DE-627 ger DE-627 rakwb eng Giani, Marco verfasserin (orcid)0000-0001-8048-2721 aut Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies. Methods We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to “conventional” ECMO management (Supine group) in patients with severe ARDS. Results 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42–1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072). Conclusions In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. The impact of this procedure will have to be definitively assessed by prospective randomized controlled trials. Acute respiratory distress syndrome (dpeaa)DE-He213 Extracorporeal membrane oxygenation (dpeaa)DE-He213 Prone positioning (dpeaa)DE-He213 Pooled data analysis (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 Rezoagli, Emanuele (orcid)0000-0002-4506-7212 aut Guervilly, Christophe (orcid)0000-0001-9066-6591 aut Rilinger, Jonathan (orcid)0000-0001-9333-3629 aut Duburcq, Thibault aut Petit, Matthieu aut Textoris, Laura aut Garcia, Bruno aut Wengenmayer, Tobias aut Grasselli, Giacomo aut Pesenti, Antonio aut Combes, Alain aut Foti, Giuseppe aut Schmidt, Matthieu aut Enthalten in Critical care London : BioMed Central, 1997 26(2022), 1 vom: 06. Jan. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:26 year:2022 number:1 day:06 month:01 https://dx.doi.org/10.1186/s13054-021-03879-w kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 26 2022 1 06 01
allfields_unstemmed	10.1186/s13054-021-03879-w doi (DE-627)SPR050340573 (SPR)s13054-021-03879-w-e DE-627 ger DE-627 rakwb eng Giani, Marco verfasserin (orcid)0000-0001-8048-2721 aut Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies. Methods We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to “conventional” ECMO management (Supine group) in patients with severe ARDS. Results 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42–1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072). Conclusions In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. The impact of this procedure will have to be definitively assessed by prospective randomized controlled trials. Acute respiratory distress syndrome (dpeaa)DE-He213 Extracorporeal membrane oxygenation (dpeaa)DE-He213 Prone positioning (dpeaa)DE-He213 Pooled data analysis (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 Rezoagli, Emanuele (orcid)0000-0002-4506-7212 aut Guervilly, Christophe (orcid)0000-0001-9066-6591 aut Rilinger, Jonathan (orcid)0000-0001-9333-3629 aut Duburcq, Thibault aut Petit, Matthieu aut Textoris, Laura aut Garcia, Bruno aut Wengenmayer, Tobias aut Grasselli, Giacomo aut Pesenti, Antonio aut Combes, Alain aut Foti, Giuseppe aut Schmidt, Matthieu aut Enthalten in Critical care London : BioMed Central, 1997 26(2022), 1 vom: 06. Jan. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:26 year:2022 number:1 day:06 month:01 https://dx.doi.org/10.1186/s13054-021-03879-w kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 26 2022 1 06 01
allfieldsGer	10.1186/s13054-021-03879-w doi (DE-627)SPR050340573 (SPR)s13054-021-03879-w-e DE-627 ger DE-627 rakwb eng Giani, Marco verfasserin (orcid)0000-0001-8048-2721 aut Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies. Methods We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to “conventional” ECMO management (Supine group) in patients with severe ARDS. Results 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42–1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072). Conclusions In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. The impact of this procedure will have to be definitively assessed by prospective randomized controlled trials. Acute respiratory distress syndrome (dpeaa)DE-He213 Extracorporeal membrane oxygenation (dpeaa)DE-He213 Prone positioning (dpeaa)DE-He213 Pooled data analysis (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 Rezoagli, Emanuele (orcid)0000-0002-4506-7212 aut Guervilly, Christophe (orcid)0000-0001-9066-6591 aut Rilinger, Jonathan (orcid)0000-0001-9333-3629 aut Duburcq, Thibault aut Petit, Matthieu aut Textoris, Laura aut Garcia, Bruno aut Wengenmayer, Tobias aut Grasselli, Giacomo aut Pesenti, Antonio aut Combes, Alain aut Foti, Giuseppe aut Schmidt, Matthieu aut Enthalten in Critical care London : BioMed Central, 1997 26(2022), 1 vom: 06. Jan. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:26 year:2022 number:1 day:06 month:01 https://dx.doi.org/10.1186/s13054-021-03879-w kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 26 2022 1 06 01
allfieldsSound	10.1186/s13054-021-03879-w doi (DE-627)SPR050340573 (SPR)s13054-021-03879-w-e DE-627 ger DE-627 rakwb eng Giani, Marco verfasserin (orcid)0000-0001-8048-2721 aut Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2022 Background Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies. Methods We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to “conventional” ECMO management (Supine group) in patients with severe ARDS. Results 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42–1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072). Conclusions In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. The impact of this procedure will have to be definitively assessed by prospective randomized controlled trials. Acute respiratory distress syndrome (dpeaa)DE-He213 Extracorporeal membrane oxygenation (dpeaa)DE-He213 Prone positioning (dpeaa)DE-He213 Pooled data analysis (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 Rezoagli, Emanuele (orcid)0000-0002-4506-7212 aut Guervilly, Christophe (orcid)0000-0001-9066-6591 aut Rilinger, Jonathan (orcid)0000-0001-9333-3629 aut Duburcq, Thibault aut Petit, Matthieu aut Textoris, Laura aut Garcia, Bruno aut Wengenmayer, Tobias aut Grasselli, Giacomo aut Pesenti, Antonio aut Combes, Alain aut Foti, Giuseppe aut Schmidt, Matthieu aut Enthalten in Critical care London : BioMed Central, 1997 26(2022), 1 vom: 06. Jan. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:26 year:2022 number:1 day:06 month:01 https://dx.doi.org/10.1186/s13054-021-03879-w kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 26 2022 1 06 01
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The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies. Methods We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to “conventional” ECMO management (Supine group) in patients with severe ARDS. Results 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42–1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072). Conclusions In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. 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spellingShingle	Giani, Marco misc Acute respiratory distress syndrome misc Extracorporeal membrane oxygenation misc Prone positioning misc Pooled data analysis misc Mortality Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis
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topic_title	Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis Acute respiratory distress syndrome (dpeaa)DE-He213 Extracorporeal membrane oxygenation (dpeaa)DE-He213 Prone positioning (dpeaa)DE-He213 Pooled data analysis (dpeaa)DE-He213 Mortality (dpeaa)DE-He213
topic	misc Acute respiratory distress syndrome misc Extracorporeal membrane oxygenation misc Prone positioning misc Pooled data analysis misc Mortality
topic_unstemmed	misc Acute respiratory distress syndrome misc Extracorporeal membrane oxygenation misc Prone positioning misc Pooled data analysis misc Mortality
topic_browse	misc Acute respiratory distress syndrome misc Extracorporeal membrane oxygenation misc Prone positioning misc Pooled data analysis misc Mortality
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title	Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis
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author_browse	Giani, Marco Rezoagli, Emanuele Guervilly, Christophe Rilinger, Jonathan Duburcq, Thibault Petit, Matthieu Textoris, Laura Garcia, Bruno Wengenmayer, Tobias Grasselli, Giacomo Pesenti, Antonio Combes, Alain Foti, Giuseppe Schmidt, Matthieu
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title_sort	prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis
title_auth	Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis
abstract	Background Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies. Methods We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to “conventional” ECMO management (Supine group) in patients with severe ARDS. Results 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42–1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072). Conclusions In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. The impact of this procedure will have to be definitively assessed by prospective randomized controlled trials. © The Author(s) 2022
abstractGer	Background Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies. Methods We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to “conventional” ECMO management (Supine group) in patients with severe ARDS. Results 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42–1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072). Conclusions In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. The impact of this procedure will have to be definitively assessed by prospective randomized controlled trials. © The Author(s) 2022
abstract_unstemmed	Background Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies. Methods We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to “conventional” ECMO management (Supine group) in patients with severe ARDS. Results 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42–1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072). Conclusions In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. The impact of this procedure will have to be definitively assessed by prospective randomized controlled trials. © The Author(s) 2022
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title_short	Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis
url	https://dx.doi.org/10.1186/s13054-021-03879-w
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author2	Rezoagli, Emanuele Guervilly, Christophe Rilinger, Jonathan Duburcq, Thibault Petit, Matthieu Textoris, Laura Garcia, Bruno Wengenmayer, Tobias Grasselli, Giacomo Pesenti, Antonio Combes, Alain Foti, Giuseppe Schmidt, Matthieu
author2Str	Rezoagli, Emanuele Guervilly, Christophe Rilinger, Jonathan Duburcq, Thibault Petit, Matthieu Textoris, Laura Garcia, Bruno Wengenmayer, Tobias Grasselli, Giacomo Pesenti, Antonio Combes, Alain Foti, Giuseppe Schmidt, Matthieu
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The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies. Methods We performed a pooled individual patient data analysis of European cohort studies which compared patients treated with prone positioning during ECMO (Prone group) to “conventional” ECMO management (Supine group) in patients with severe ARDS. Results 889 patients from five studies were included. Unadjusted ICU mortality was 52.8% in the Supine Group and 40.8% in the Prone group. At a Cox multiple regression analysis PP during ECMO was not significantly associated with a reduction of ICU mortality (HR 0.67 95% CI: 0.42–1.06). Propensity score matching identified 227 patients in each group. ICU mortality of the matched samples was 48.0% and 39.6% for patients in the Supine and Prone group, respectively (p = 0.072). Conclusions In a large population of ARDS patients receiving venovenous extracorporeal support, the use of prone positioning during ECMO was not significantly associated with reduced ICU mortality. 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Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis

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