Randomized, open, controlled study to evaluate early prone position in awake patients on spontaneous ventilation with mild to moderate respiratory distress syndrome secondary to COVID-19 - APC Trial : APC Trial - Awake Proning on COVID-19 Trial

Rodrigo S Biondi0 个研究点开始时间: 2020年8月10日最近更新: 2023年5月29日

适应症

试验速览

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•Patients with COVID-19 confirmed by RT-PCR or strong suspicion, defined as both typical clinical picture and typical chest CT scan. Presence of bilateral infiltrate on chest tomography and one of the following two: Patient with SpO2 below 94% in room air or Need for O2 by nasal catheter above 4L per min to maintain SpO2 above 94%

•Denial of the patient or physician or assistant team to participate in the study. Evident signs of ventilatory fatigue (RF greater than 30irpm, PaCO2 greater than 45mmHg, with pH less than 7.35 and use of evident accessory musculature with indication of imminent intubation
•# Need more than 5 EPAP and 5 IPAP in NIV. Hemodynamic instability (need for Noradrenaline above 0.3mcg per kg per min). Respiratory failure (IRPA) with estimated intubation in the next 6 hours. Cervical, sternotomy or facial surgery less than 15 days ago. Impossibility of collecting arterial blood gases. Evidence or strong suspicion of a cause of IRPA other than COVID pneumonia. Disorientation. Pregnant women with a pregnant abdomen. Have participated in the study previously. Exclusive palliative care. Any clinical impossibility of prone position such as instability or fracture of the spine, pelvis or femur; Massive hemoptysis in need of surgical intervention; Anterior thoracic drain with air leak; Presence of pacemaker installed less than 2 days ago

发起方

Rodrigo S Biondi