Early conscious prone positioning in patients with COVID-19 receiving continuous positive airway pressure: a retrospective analysis.
BMJ Open Respir Res
; 7(1)2020 09.
Artículo
en Inglés
| MEDLINE | ID: covidwho-748811
ABSTRACT
The global pandemic of COVID-19 has challenged the management of hypoxaemic respiratory failure and strained intensive care unit resources. While prone positioning (PP) is an established therapy in mechanically ventilated patients with acute respiratory distress syndrome (ARDS), its role in conscious patients is less well defined. We retrospectively reviewed our experience of implementing early PP in a cohort of 24 patients with acute hypoxaemic respiratory failure due to COVID-19 who required support with continuous positive airway pressure (CPAP). The use of PP alongside CPAP significantly increased both the ROX index and arterial oxygen pressurefractional inspired oxygen (PaO2FiO2) ratio from baseline values (ROX index 7.0±2.5 baseline vs 11.4±3.7 CPAP+PP, p<0.0001; PaO2FiO2 ratio 143±73 mm Hg baseline vs 252±87 mm Hg CPAP+PP, p<0.01), and the changes to both the ROX index and PaO2FiO2 ratio remained significant 1 hour after cessation of proning. The mean duration of PP in the first 24 hours was 8±5 hours. Few complications were observed and PP was continued for a mean of 10±5 days. From our experience in a dedicated COVID-19 respiratory high care unit, PP alongside CPAP therapy was feasible, tolerated, safe and improved oxygenation. The use of conscious PP in ARDS warrants further investigation in randomised controlled trials.
Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Neumonía Viral
/
Infecciones por Coronavirus
/
Presión de las Vías Aéreas Positiva Contínua
/
Posicionamiento del Paciente
/
Betacoronavirus
Tipo de estudio:
Estudio de cohorte
/
Estudio experimental
/
Estudio observacional
/
Estudio pronóstico
/
Ensayo controlado aleatorizado
Límite:
Femenino
/
Humanos
/
Masculino
/
Middle aged
Idioma:
Inglés
Año:
2020
Tipo del documento:
Artículo
País de afiliación:
Bmjresp-2020-000711
Similares
MEDLINE
...
LILACS
LIS