AI Article Synopsis
- The study investigates the effects of proning (turning patients onto their stomachs) on oxygenation in mechanically ventilated COVID-19 patients with acute respiratory distress syndrome (ARDS).
- The research involved 44 patients and found significant improvements in oxygen levels during the first three proning sessions, particularly in those with lower oxygenation levels (PaO2:FiO2 < 120 mm Hg).
- It suggests that proning can benefit a broad range of patients with COVID-19 ARDS, although further studies are needed to assess its impact on mortality.
Article Abstract
Background: The management of COVID-19 ARDS is debated. Although current evidence does not suggest an atypical acute respiratory distress syndrome (ARDS), the physiological response to prone positioning is not fully understood and it is unclear which patients benefit. We aimed to determine whether proning increases oxygenation and to evaluate responders.
Methods: This case series from a single, tertiary university hospital includes all mechanically ventilated patients with COVID-19 and proning between 17 March 2020 and 19 May 2020. The primary measure was change in PaO :FiO .
Results: Forty-four patients, 32 males/12 females, were treated with proning for a total of 138 sessions, with median (range) two (1-8) sessions. Median (IQR) time for the five sessions was 14 (12-17) hours. In the first session, median (IQR) PaO :FiO increased from 104 (86-122) to 161 (127-207) mm Hg (P < .001). 36/44 patients (82%) improved in PaO :FiO , with a significant increase in PaO :FiO in the first three sessions. Median (IQR) FiO decreased from 0.7 (0.6-0.8) to 0.5 (0.35-0.6) (<0.001). A significant decrease occurred in the first three sessions. PaO , tidal volumes, PEEP, mean arterial pressure (MAP), and norepinephrine infusion did not differ. Primarily, patients with PaO :FiO approximately < 120 mm Hg before treatment responded to proning. Age, sex, BMI, or SAPS 3 did not predict success in increasing PaO :FiO .
Conclusion: Proning increased PaO :FiO , primarily in patients with PaO :FiO approximately < 120 mm Hg, with a consistency over three sessions. No characteristic was associated with non-responding, why proning may be considered in most patients. Further study is required to evaluate mortality.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894343 | PMC |
| http://dx.doi.org/10.1111/aas.13741 | DOI Listing |
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