Vertical Positioning for Respiratory Failure

Overseen By John P Kress, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Chicago

Disqualifiers: Pregnancy, Myocardial ischemia, Intracranial pressure, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

16 Participants Needed

Trial Summary

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Standing for respiratory failure?

Research shows that changing body positions, like moving patients to a prone (face down) position, can improve oxygen levels in people with acute respiratory failure. This suggests that different body positions, including standing, might help improve breathing by enhancing gas exchange in the lungs. ^{1 2 3 4 5}

Is vertical positioning safe for respiratory failure treatment?

Prone positioning, a type of vertical positioning, is generally safe but can have some complications like facial swelling, skin pressure sores, and regurgitation of food. These issues are manageable with proper care and protocols. ^{6 7 8 9 10}

How does the standing treatment for respiratory failure differ from other treatments?

The standing treatment for respiratory failure is unique because it involves vertical positioning, which may improve oxygenation by enhancing lung function and diaphragm recovery. Unlike traditional methods like prone or supine positioning, standing could potentially offer benefits such as better ventilation-perfusion matching and increased lung capacity, though its effectiveness needs further clinical testing. ^{1 3 4 5 11}

What is the purpose of this trial?

The purpose of this study is to investigate how changing from a supine to upright position affects gas exchange for patients with hypoxemic respiratory failure. The research question is: will oxygen saturation and/or partial pressure of oxygen in the blood change when a patient with hypoxemic respiratory failure moves from a supine to upright position?

Research Team

John P Kress, MD

Principal Investigator

University of Chicago

Eligibility Criteria

This trial is for adults over 18 who are on mechanical ventilation due to respiratory failure, with specific oxygen levels in their blood. It's not for those with severe heart rates, low blood pressure, gastrointestinal bleeding, high intracranial pressure, pregnancy, or if they weren't walking before hospitalization.

Inclusion Criteria

I am 18 or older and am on a mechanical ventilator.

People with oxygen levels between 88% and 94% or who have an arterial line.

Exclusion Criteria

Your breathing rate is too slow (less than 5 breaths per minute) or too fast (more than 40 breaths per minute).

You have signs of increased pressure inside your head.

I have active heart-related chest pain.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Intervention

Participants are assisted to move from a supine to an upright position to assess changes in gas exchange

Single session

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the intervention

1 hour

Treatment Details

Interventions

• Standing

Trial Overview The study examines the impact of moving from lying down to standing up on breathing and oxygen levels in patients with hypoxemic respiratory failure. Researchers want to see if this change improves how well lungs transfer oxygen into the blood.

Participant Groups

Group I: Mechanically Ventilated Experimental Treatment 1 Intervention

Who Is Running the Clinical Trial?

University of Chicago

Lead Sponsor

Trials

1,086

Recruited

844,000+

References

1. Germany pubmed.ncbi.nlm.nih.gov

[Continuously alternating prone and supine positioning in acute lung failure]. [2020]

2. United States pubmed.ncbi.nlm.nih.gov

Does gas exchange response to prone position predict mortality in hypoxemic acute respiratory failure? [2020]

3. United States pubmed.ncbi.nlm.nih.gov

Effect of prone positioning on the survival of patients with acute respiratory failure. [2022]

4. England pubmed.ncbi.nlm.nih.gov

A randomized trial on the effects of body positions on lung function with acute respiratory failure patients. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

4A randomized trial of prolonged prone positioning in children with acute respiratory failure. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Adverse Events of Prone Positioning in Mechanically Ventilated Adults With ARDS. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Short-term effects of prone position in chronic obstructive pulmonary disease patients with severe acute hypoxemic and hypercapnic respiratory failure. [2018]

8. Brazil pubmed.ncbi.nlm.nih.gov

Fluid balance in pediatric patients in prone position: a pragmatic study. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Prone Positioning During Extracorporeal Membrane Oxygenation in Patients With Severe ARDS: The PRONECMO Randomized Clinical Trial. [2023]

10. Spain pubmed.ncbi.nlm.nih.gov

[Prone position: postural treatment for patients with adult respiratory distress syndrome. The nurse's point of view]. [2020]

11. United States pubmed.ncbi.nlm.nih.gov

Upright position mechanical ventilation: an alternative strategy for ALI/ARDS patients? [2020]