Prone Position Improves Oxygenation In Non intubated ICU Patients of COVID-19

It was a prospective observational study in seven awake patients with moderate or severe ARDS by COVID-19 admitted to the ICU at University Hospital of Santiago from March 21 to April 5, 2020. All patients received at least 1 PP session and were advised to remain in PP as long as possible until the patient felt too tired to maintain that position. A total of 16 PP sessions were performed in the 7 patients during the period study. They administered light sedation with dexmedetomidine and evaluated the following information: number and duration of PP sessions; tissue O2 saturation (Sto2) and blood gases before, during, and following a PP session; the need of mechanical ventilation; duration of ICU admission; and ICU outcome.

Key findings of the study were:

♦The median duration of PP sessions was 10 hours.

♦Researchers found that Oxygenation was increased in all 16 sessions performed in the 7 patients.

♦They also found that the ratio of arterial oxygen partial pressure to fractional inspired oxygen (Pao2/Fio2) significantly increased during PP (change from baseline 110) without significant changes after PP in the supine position.

♦They also observed small improvement in tissue oxygenation during PP (change from baseline 2.6%) without significant changes after PP.

♦They reported that two patients required intubation and all patients had well-tolerated PP sessions and discharged from ICU.

The authors concluded, "We found that PP improved oxygenation in ICU patients with COVID-19 and moderate or severe ARDS. PP was relatively well tolerated in our patients and maybe a simple strategy to improve oxygenation trying to reduce the number of patients in mechanical ventilation and the length of stay in the ICU, especially in COVID-19 pandemic".

For further information:

https://journals.lww.com/anesthesia-analgesia/Fulltext/2021/01000/Effectiveness_of_Prone_Positioning_in_Nonintubated.4.aspx