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A landmark trial published in 2013 established prone positioning as a lifesaving strategy in ventilated patients with severe acute respiratory distress syndrome (NEJM JW Gen Med Jul 14 2013 and N Engl J Med 2013; 368:2159). During the COVID-19 pandemic, awake prone positioning emerged as a potential early intervention to prevent clinical deterioration, but a small study did not show benefit (NEJM JW Gen Med Jul 1 2022 and JAMA 2022; 327:2104). To evaluate the benefit of this approach, investigators conducted an individual-patient data meta-analysis of 14 randomized trials in which the effect of awake prone positioning was compared with standard care in 3000 patients with COVID-19 and acute hypoxemic respiratory failure.
Results were as follo…