Effect of awake prone position ventilation on clinical outcomes in patients with acute respiratory distress syndrome

Jia Wenqing; Wang Wenjing; Hu Chunhua; Shao Huanzhang

doi:10.3760/j.issn.1673-4777.2026.06.009

Abstract：Objective To investigate the effect of awake prone position(APP)ventilation on clinical outcomes in patients with acute respiratory distress syndrome(ARDS).Methods Clinical data of 114 patients with ARDS admitted to Henan Provincial People's Hospital from January 2022 to January 2024 were retrospectively analyzed.Patients were divided into APP group(64 cases)receiving APP ventilation and supine position group(50 cases)receiving standard treatment.Endotracheal intubation rate and 28 d mortality were compared between the two groups.Furthermore,patients in the APP group were divided into early APP group(39 cases)and delayed APP group(25 cases)according to whether the initial time of APP was＞24 h after admission,to explore the effect of APP initiation timing on treatment outcomes.Results The endotracheal intubation rate in the APP group was lower than that in the supine position group[31.2％(20/64)vs 44.0％(22/50)](P＜0.05),but there was no significant difference in mortality between the two groups(P＞0.05).The respiratory rate-oxygenation index,oxygenation index,respiratory rate and diaphragm thickening fraction at the last hour of APP ventilation and 1 h af-ter restore supine position were all superior to those before the first APP ventilation,with statistically significant differences(all P＜0.05).The endotracheal intubation rate in the early APP group was lower than that in the delayed APP group[10.3％(4/39)vs 64.0％(16/25)](P＜0.001),but there was no significant difference in 28 d mortality between the two subgroups(P=0.221).Conclusions Early APP ventilation can effectively reduce the endotracheal intubation rate and improve clinical symptoms and physiological indicators in patients with ARDS.