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Collegian . Effect of Prone Position on Clinical Outcomes of Non-Intubated Patients with Covid-19: A Randomized Clinical Trial

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  • Collegian . Effect of Prone Position on Clinical Outcomes of Non-Intubated Patients with Covid-19: A Randomized Clinical Trial


    Collegian


    . 2022 Dec 27.
    doi: 10.1016/j.colegn.2022.12.005. Online ahead of print.
    Effect of Prone Position on Clinical Outcomes of Non-Intubated Patients with Covid-19: A Randomized Clinical Trial


    Sajad Yarahmadi 1 , Farzad Ebrahimzadeh 2 , Fatemeh Mohamadipour 1 , Tayebeh Cheraghian 1 , Mahtab Eskini 3



    Affiliations

    Abstract

    Background: Prone positioning (PP) is a well-known respiratory support approach. Limited data are available for the use of PP in non-intubated patients with COVID-19.
    Aim: This study aims to investigate the effect of PP on the clinical outcomes of patients with COVID-19 pneumonia.
    Methods: In This clinical trial, the participants in the PP group (n=41) were asked to lie comfortably in a prone position for 90 minutes. In the supine position (SP) group (n=41), the participants were asked to lie comfortably in a supine position for 90 minutes. Clinical data such as oxygen saturation, respiratory rate, the severity of dyspnea, mean arterial pressure, and pulse rate were assessed at 0 (immediately before), 30, 60, 90 minutes after the start of the intervention and 30 min after resuming the supine position. The participants in the PP group were then asked to intermittently stay in a prone position for a total of eight hours per 24 hours of hospitalization. The participants in the control group were asked to remain in their usual positions during the hospital stay. Finally, the length of hospital stay, intubation rate, and survival assessed.
    Findings: Prone positioning was associated with significant improvement in oxygen saturation (P = 0.001), respiratory rate (P=0.004), the severity of dyspnea (P=0.014), and mean arterial pressure (P=0.027). There was no significant difference between the two groups in terms of pulse rate (P=0.890), hospital stay (P=0.994), intubation rate (P=0.324), and survival (P=0.091).
    Discussion: Our results demonstrated that prone positioning showed marked improvement in some short-term clinical outcomes in non-intubated patients with COVID-19.
    Conclusion: Prone positioning can be considered an inexpensive, accessible, and simple measure in awake non-intubated patients with COVID-19.

    Keywords: Acute respiratory distress syndrome; Coronavirus; Covid-19; Prone Position.

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