anaesthetic & critical care studies summaries

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Protocol v5.0 03/07/2025
Rotherham Principal Investigator: Professor Anil Hormis
Research team member: Dr Katie Webb

research topic:

Effect of awake prone positioning on need for tracheal intubation (not due to COVID-19)

trial groups:

Intervention: Conscious prone position for ≥8hrs / day 
Control: ​Usual care (semi recumbent with 30⁰-90⁰ head elevation or slight side tilt)

inclusion criteria:

• ​Hospitalised adult (aged ≥18 years) who is not intubated—does not need to be within critical care patients elsewhere can also be recruited
  
• Acute respiratory failure (sustained SpO2≤94% on ≥40% oxygen)
  
• Deemed suitable for intubation if deterioration
   
  

exclusion criteria:

• Hypoxaemia caused by pulmonary oedema secondary to heart failure
  
• Unwilling to attempt awake prone positioning
  
• COVID-19 pneumonitis as the main cause of respiratory failure
  
• Contraindication to awake prone positioning
  
• Previously ventilated during current admission (except to facilitate a procedure or operation)

consent:

Formal consent is required for Awake Prone trial enrolment/randomisation.
​If you think your patient is in any way eligible please contact the research team who will review the full inclusion/exclusion criteria and approach for consent.
 

running the intervention:

If randomised to the intervention group the patient is advised to lay prone position over a maximum of 5 days/120 hours from randomisation. The daily target is for awake prone positioning for ≥8hrs / day  this can be a single long period or several shorter periods.
Participants will lie prone as long as frequently as feasible.
A beside patient booklet for positioning advice and a chart for nursing staff to record timings will be provided. The intervention stops after : 120 hours, intubation, or patient deemed recovered.