Vertical Positioning for Respiratory Failure

AP
John P Kress, MD profile photo
Overseen ByJohn P Kress, MD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of Chicago
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether transitioning from lying down to standing can improve breathing in people with hypoxemic respiratory failure, a condition characterized by insufficient oxygen in the blood. Researchers aim to determine if standing affects oxygen levels in patients on a ventilator. Suitable participants are adults on a ventilator with oxygen levels between 88-94%. As an unphased trial, this study offers participants the chance to contribute to innovative research that could lead to new methods for improving breathing in those with respiratory failure.

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 prior data suggests that this positioning technique is safe for patients with hypoxemic respiratory failure?

Research shows that changing a patient's position can help with breathing problems. When patients with breathing issues move from lying down to sitting up, their lung function can improve. Studies have found that sitting up allows more air to enter the lungs.

No reports indicate serious side effects from simply sitting a patient up. Hospitals often use this position for various reasons, and it is generally considered safe. Although the research does not specifically address the safety of this practice, the absence of reported problems suggests it is well-tolerated.12345

Why are researchers excited about this trial?

Researchers are excited about exploring vertical positioning, specifically standing, for patients with respiratory failure because it offers a non-invasive alternative to traditional mechanical ventilation strategies. Unlike typical treatments that focus on mechanical lung support, standing may enhance lung function by leveraging gravity to improve ventilation and oxygenation naturally. This approach could potentially minimize complications associated with prolonged mechanical ventilation, such as muscle atrophy and ventilator-associated lung injury, providing a simpler and potentially safer option for respiratory support.

What evidence suggests that changing to an upright position is effective for hypoxemic respiratory failure?

Research shows that changing a patient's position can greatly impact breathing in people with hypoxemic respiratory failure, a serious condition where blood oxygen levels are too low. Studies have found that standing or sitting up can help improve oxygen levels in the blood. This trial will investigate the effects of standing on oxygen levels in patients who are mechanically ventilated. One study discovered that being upright can help the lungs work better, especially for patients using a breathing machine. Another study suggested that lying face down can also help, indicating that standing might offer similar benefits. This makes studying the effect of standing on oxygen levels in these patients promising.26789

Who Is on the Research Team?

JP

John P Kress, MD

Principal Investigator

University of Chicago

Are You a Good Fit for This Trial?

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

Pregnancy
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.
See 11 more

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Mechanically VentilatedExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Chicago

Lead Sponsor

Trials
1,086
Recruited
844,000+

Citations

Use of body positioning in the mechanically ventilated patient ...CINAHL using the keywords '('patient-positioning' or 'posture') and 'ventilation-mechanical' and 'respiratory- failure'. 3. EMBASE using the keywords 'body- ...
Body position for preventing ventilator-associated pneumonia ...Effect of mechanical ventilation in the prone position on clinical outcomes in patients with acute hypoxemic respiratory failure: a ...
A Comprehensive Review of Prone Ventilation in the Intensive ...... positioning during mechanical ... position mechanical ventilation to treat acute coronavirus disease 2019 hypoxemic respiratory failure.
Physiological effects and safety of bed verticalization in ...... position in ARDS patients under mechanical ventilation significantly affects respiratory mechanics. ... respiratory failure. Chest. 1980;77 ...
Prone Positioning for Acute Hypoxemic Respiratory Failure ...... position in respiratory failure. ... Esteban et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study ...
Impact of vertical positioning on lung aeration among ...Reason for mechanical ventilation. Acute respiratory failure, 11 (57.9). Hemodynamic instability, 1 (5.3). Decreased level of consciousness, 5 (26.3). Cardiac ...
Prone Positioning for Acute Hypoxemic Respiratory Failure ...Conclusions. The use of the prone position has numerous physiologic benefits in patients with acute hypoxemic respiratory failure and ARDS.
Upright position mechanical ventilation: An alternative ...Sud et al. Effect of mechanical ventilation in the prone position on clinical outcomes in patients with acute hypoxemic respiratory failure: a systematic review ...
Guideline on positioning and early mobilisation in the ...In obese patients undergoing prone positioning, an increased rate of hypoxic hepatitis and renal failure was present, without a mortality ...
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