Your browser doesn't support javascript.
Proning in Non-Intubated (PINI) in Times of COVID-19: Case Series and a Review.
Paul, Vishesh; Patel, Shawn; Royse, Michelle; Odish, Mazen; Malhotra, Atul; Koenig, Seth.
  • Paul V; Department of Pulmonary & Critical Care Medicine, Carle Foundation Hospital, Urbana, IL, USA.
  • Patel S; Department of Family Medicine, Carle Foundation Hospital, Urbana, IL, USA.
  • Royse M; Department of Pulmonary & Critical Care Medicine, Carle Foundation Hospital, Urbana, IL, USA.
  • Odish M; Department of Pulmonary & Critical Care Medicine, University of California, San Diego, CA, USA.
  • Malhotra A; Department of Pulmonary & Critical Care Medicine, University of California, San Diego, CA, USA.
  • Koenig S; Department of Pulmonary & Critical Care Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
J Intensive Care Med ; 35(8): 818-824, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: covidwho-634271
ABSTRACT
It has been well known for decades that prone positioning (PP) improves oxygenation. However, it has gained widespread acceptance only in the last few years since studies have shown significant survival benefit. Many centers have established prone ventilation in their treatment algorithm for mechanically ventilated patients with severe acute respiratory distress syndrome (ARDS). Physiologically, PP should also benefit awake, non-intubated patients with acute hypoxemic respiratory failure. However, proning in non-intubated (PINI) patients did not gain any momentum until a few months ago when the Coronavirus disease 2019 (COVID-19) pandemic surged. A large number of sick patients overwhelmed the health care system, and many centers faced a dearth of ventilators. In addition, outcomes of patients placed on mechanical ventilation because of COVID-19 infection have been highly variable and often dismal. Hence, increased focus has shifted to using various strategies to prevent intubation, such as PINI. There is accumulating evidence that PINI is a low-risk intervention that can be performed even outside intensive care unit with minimal assistance and may prevent intubation in certain patients with ARDS. It can also be performed safely at smaller centers and, therefore, may reduce the patient transfer to larger institutions that are overwhelmed in the current crisis. We present a case series of 2 patients with acute hypoxemic respiratory failure who experienced significant improvements in oxygenation with PP. In addition, the physiology of PP is described, and concerns such as proning in obese and patient's anxiety are addressed; an educational pamphlet that may be useful for both patients and health care providers is provided.
Asunto(s)

Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Tipo del documento: Artículo Asunto principal: Ansiedad / Neumonía Viral / Insuficiencia Respiratoria / Posición Prona / Infecciones por Coronavirus / Posicionamiento del Paciente / Pandemias / Obesidad Tipo de estudio: Informe de casos / Estudio de etiologia / Investigación cualitativa Idioma: Inglés Revista: J Intensive Care Med Aspecto clínico: Etiología Año: 2020

Similares

MEDLINE

...
LILACS

LIS


Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Tipo del documento: Artículo Asunto principal: Ansiedad / Neumonía Viral / Insuficiencia Respiratoria / Posición Prona / Infecciones por Coronavirus / Posicionamiento del Paciente / Pandemias / Obesidad Tipo de estudio: Informe de casos / Estudio de etiologia / Investigación cualitativa Idioma: Inglés Revista: J Intensive Care Med Aspecto clínico: Etiología Año: 2020