Proning Intervention to Facilitate ECMO Weaning in Severe ARDS (PRIME Study) – A Randomized Controlled Multi-Center Trial

• Applicant: Privatdozent Dr. Alexander Supady
• Subject Area: Pneumology, Thoracic Surgery
• Term: since 2026
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 554212787

The Acute Respiratory Distress Syndrome (ARDS) is frequent in mortality is high. Survival of patients with very severe ARDS supported with extracorporeal membrane oxygenation (ECMO) is less than 50%. In ARDS patients without ECMO, prone positioning significantly reduces mortality. Retrospective data suggest that prone positioning has a significant survival benefit in patients with ECMO, too. However, in a randomized controlled trial in patients with COVID-19 and ECMO, prone positioning was not associated with a shorter time to successful weaning from ECMO nor with a survival benefit. Significant pathophysiologic differences have been described between COVID-19 ARDS and ARDS of other causes, so it is not clear whether and to what extent the observations of patients with COVID-19 can be transferred to patients with non-COVID-19 ARDS. Consequently, further high-quality prospective data is imperative to prevent the inadvertent or premature exclusion of ECMO patients from the well-established life-saving intervention of prone positioning in ARDS. The aim of this study is to investigate the impact of prone positioning on survival of patients with very severe ARDS and ECMO. The hypothesis is that early prone positioning after initiation of ECMO increases the chance of survival compared to supine positioning.

• DFG Programme: Clinical Trials