Duration of the first prone positioning maneuver and its association with 90-day mortality in patients with acute respiratory failure due to COVID-19: A retrospective study of time terciles

Objective: To investigate the association between the duration of the first prone positioning maneuver (PPM) and 90-day mortality in patients with C-ARDS. Design: Retrospective, observational, and analytical study. Setting: COVID-19 ICU of a tertiary hospital. Patients: Adults over 18 years old, with a confirmed diagnosis of SARS-CoV-2 disease requiring PPM. Interventions: Multivariable analysis of 90-day survival. Main variables of interest: Duration of the first PPM, number of PPM sessions, 90-day mortality. Results: 271 patients undergoing PPM were analyzed: first tertile (n = 111), second tertile (n = 95) and third tertile (n = 65). The results indicated that the median duration of PDP was 14 hours (95% CI: 10-16 hours) in the first tertile, 19 hours (95% CI: 18-20 hours) in the second tertile and 22 hours (95% CI: 21-24 hours) in the third tertile. Comparison of survival curves using the Logrank test did not reach statistical significance (P P = .11). Cox Regression analysis showed an association between the number of pronation sessions- patients receiving between 2 and 5 sessions (HR: 2.19; 95% CI: 1.07-4.49) and those receiving more than 5 sessions (HR: 6.05; 95% CI: 2.78-13.16-and 90-day mortality. Conclusions: While the duration of PDP does not appear to significantly influence 90-day mortality, the number of pronation sessions is identified as a significant factor associated with an increased risk of mortality. (c) 2024 Elsevier Espana, a, S.L.U. y SEMICYUC. All rights reserved.