Objective: To describe the characteristics of patients with acute respiratory distress syndrome due to bilateral COVID-19 pneumonia on invasive mechanical ventilation (IMV) and analyze the effect of prolonged prone decubitus > 24 h (PPD) compared to prone decubitus < 24 h (PD).
Design: Retrospective observational descriptive study. Uni and bivariate analysis.
Setting: Department of Intensive Care Medicine. General University Hospital of Elche.
Participants: Patients with SARS-CoV-2 pneumonia (2020-2021) in VMI for moderate-severe acute respiratory distress syndrome, ventilated in PD.
Interventions: IMV. PD maneuvers.
Main Variables Of Interest: Sociodemographic; analgo-sedation; neuromuscular blockade; PD (duration), ICU stay and mortality, days of IMV; non-infectious complications; health care-associated infections.
Results: Fifty-one patients required PD and of these 31 (69.78%) required PPD. No differences were found in patient characteristics (sex, age, comorbidities, initial severity, antiviral and anti-inflammatory treatment received). Patients on PPD had lower tolerance to supine ventilation (61.29 vs. 89.47%, = 0.031), longer hospital stay (41 vs. 30 days, = 0.023), more days of IMV (32 vs. 20 days, = 0.032), longer duration of neuromuscular blockade (10.5 vs. 3 days, = 0.0002), as well as a higher percentage of episodes of orotracheal tube obstruction (48.39 vs. 15%, = 0.014).
Conclusions: PPD was associated with higher resource use and complications in patients with moderate-severe acute respiratory distress syndrome by COVID-19.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10008791 | PMC |
| http://dx.doi.org/10.1016/j.medin.2023.03.002 | DOI Listing |
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