ABSTRACT
PURPOSE: We aimed to evaluate and compare the efficacy and complications of three consecutive prone positions (PP) in COVID-19 ICU. MATERIALS AND METHOD: Patients with ARDS and placed in PP for 3 times (PP1, PP2, PP3) consecutively were included. Arterial blood gases (ABG), partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FiO2) ratios, partial pressure of carbondioxide (PaCO2), PEEP, and FiO2 were recorded before (bPP), during (dPP), and after (aPP) every prone positioning. Eye, skin, nerve, and tube complications related to PP were collected. RESULTS: In all positions, PaO2 value during PP was significantly higher than PaO2 before and after prone position (p = 0.001). PaO2 values were similar in all (PP1, PP2, PP3) bPP arterial blood gases. We found difference in PaO2 values during prone position between the first (PP1) and second proning (PP2). When each prone was evaluated within itself, PaO2/FiO2 increases after proning compared to before proning. PaO2/FiO2 during PP were higher compared to before proning ones. PaO2/FiO2 during PP1 was significantly higher compared to during PP3 (p = 0.005). In PP3, PEEP values bPP, dPP, and aPP were significantly higher than PEEP values after the second prone (p = 0.02, p = 0.001, p = 0.01). In the third prone, PaCO2 levels were higher than in PP1 and PP2. There were eye complications in 13, tube-related complications in 10, skin complications in 30, and nerve damage in 1 patient. CONCLUSION: We believe that a more careful decision should be made after the second prone position in patients who have to be placed in sequential prone position.
ABSTRACT
We aimed to examine the relationship between hypoxemia, inflammatory parameters, cytokine storm and mortality in the COVID-19 Intensive Care Unit. COVID-19 patients followed in intensive care unit between 21 March and 1 June 2020 were retrospectively an alyzed. Inflammatory parameters (CRP, ferritin, D Dimer, leukocyte and lymphocyte, LDH...) were measured in blood samples taken simultaneously. The relationship of these parameters with mortality was evaluated. Of the 30 patients, 11 (36.7%) were female, 19 (63.3%) were male. When living (Group 1) and dead (Group 2) patient groups were compared, a statistically significant difference was found between the groups in terms of mean age (p = 0.013). It was observed that PaO2 / FiO2 ratios were lower in Group 2 in all measurements starting from the day of hospitalization in intensive care. While there was no difference between CRP and procalcitonin values in the first week, the 12th and last day measurements were found to be statistically significantly higher in Group 2 (respectively p2 = 0.050, p2 = 0.016;p2 = 0.050, p2 <0.001). When the patients with severe pneumonia treated in the intensive care unit with the diagnosis of COVID-19 were examined, it was observed that the patients who died were more hypoxic at the intensive care entrance and on the 3rd day compared to the survivors, the level of hypoxemia did not affect the cytokine storm, and there was no difference in mortality between those who experienced cytokine storm and those who did not. [ FROM AUTHOR] Copyright of Eastern Journal of Medicine is the property of Yuzuncu Yil University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)