Table 1 Basic information of included studies
Author | Year | Country | Study type | Disease | Oxygen supply | Setting | Awake prone positioning | Standard care | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sample size | Age | Care details | Sample size | Age | Care details | |||||||
Jayakumar | 2021 | India | RCT | COVID‑19‑induced AHRF | Nasal prong, face mask, NRB, HFNC, NIV | ICU | 30 | 54.8 ± 11.1 | Awake prone positioning for at least 6 h per day | 30 | 57.3 ± 12.1 | Those patients were permitted to change positions as needed for their comfort (supine, semirecumbent, sitting or lateral) |
Gad | 2021 | Egypt | RCT | COVID‑19‑induced AHRF | NRB | ICU | 15 | 49.0 (38–62) | Each session last for 1 to 2 h according to patient to tolerability with 3hs apart during waking hours | 15 | 46.0 (33–51) | Unrestricted body position |
Fralick | 2022 | Canada | RCT | COVID‑19‑induced AHRF | Nasal prong, face mask, HFNC | General ward | 126 | 59.5 (45–68) | Awake prone positioning for four times a day (up to two hours for each session) and encouraged to sleep in awake prone positioning overnight | 122 | 54 (44–62) | Unrestricted body position |
Rosén | 2021 | Sweden | RCT | COVID‑19‑induced AHRF | HFNC or NIV | General ward | 36 | 66 (53–74) | At least 16 h awake prone positioning per day. Prone and semi-prone positioning was allowed | 39 | 65 (55–70) | Unrestricted body position |
Ibarra | 2022 | Mexico | RCT | COVID‑19‑induced AHRF | HFNC | High-acuity units | 216 | 58.6 ± 15.8 | Patients in the awake prone positioning group were consistently encouraged by the bedside clinicians to remain in awake prone positioning | 214 | 58.2 ± 15.8 | awake prone positioning was discouraged. If awake prone positioning was performed for ≥ 1 h, patients were excluded from the per-protocol analysis |
Alhazzani | 2022 | Canada | RCT | COVID‑19‑induced AHRF | HFNC | ICU | 205 | 56.8 ± 12.5 | Awake prone positioning was 8 h/d to 10 h/d with 2 to 3 breaks (1–2 h each) | 195 | 58.3 ± 13.2 | Nurses instructed patients not to position themselves in the prone position |
Ehrmann | 2021 | France | RCT | COVID‑19‑induced AHRF | HFNC | ICU/General ward | 564 | 61.5 ± 13.3 | Patients were instructed and assisted to lie in the prone position for as long and as frequently as possible each day | 557 | 60.7 ± 14 | Patients received standard care with high-flow nasal cannula. The use of Awake prone positioning as intervention was discouraged |
Rampon | 2022 | USA | RCT | COVID‑19‑induced HRF | HFNC | General ward | 159 | 52 (39–62) | Four times daily for 1 to 2 h each session and nightly for a total of 12 h | 134 | 54 (43–63) | Lie in bed in whichever position was comfortable |