tetano
Editor, Senior Moderator
BMC Res Notes
. 2021 Jan 9;14(1):20.
doi: 10.1186/s13104-020-05426-2.
Prone positioning improves oxygenation and lung recruitment in patients with SARS-CoV-2 acute respiratory distress syndrome; a single centre cohort study of 20 consecutive patients
Jennifer Clarke[SUP] 1 2 [/SUP], Pierce Geoghegan[SUP] 1 2 [/SUP], Natalie McEvoy[SUP] 1 2 [/SUP], Maria Boylan[SUP] 2 [/SUP], Orna N? Choile?in[SUP] 2 [/SUP], Martin Mulligan[SUP] 2 [/SUP], Grace Hogan[SUP] 1 [/SUP], Aoife Keogh[SUP] 1 [/SUP], Oliver J McElvaney[SUP] 2 [/SUP], Ois?n F McElvaney[SUP] 2 [/SUP], John Bourke[SUP] 3 [/SUP], Bairbre McNicholas[SUP] 3 [/SUP], John G Laffey[SUP] 3 [/SUP], Noel G McElvaney[SUP] 2 [/SUP], Gerard F Curley[SUP] 4 5 [/SUP]
Affiliations
Abstract
Objective: We aimed to characterize the effects of prone positioning on respiratory mechanics and oxygenation in invasively ventilated patients with SARS-CoV-2 ARDS.
Results: This was a prospective cohort study in the Intensive Care Unit (ICU) of a tertiary referral centre. We included 20 consecutive, invasively ventilated patients with laboratory confirmed SARS-CoV-2 related ARDS who underwent prone positioning in ICU as part of their management. The main outcome was the effect of prone positioning on gas exchange and respiratory mechanics. There was a median improvement in the PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ratio of 132 in the prone position compared to the supine position (IQR 67-228). We observed lower PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ratios in those with low (< median) baseline respiratory system static compliance, compared to those with higher (> median) static compliance (P < 0.05). There was no significant difference in respiratory system static compliance with prone positioning. Prone positioning was effective in improving oxygenation in SARS-CoV-2 ARDS. Furthermore, poor respiratory system static compliance was common and was associated with disease severity. Improvements in oxygenation were partly due to lung recruitment. Prone positioning should be considered in patients with SARS-CoV-2 ARDS.
Keywords: Adult; Prone position; Respiratory distress syndrome; Severe acute respiratory syndrome coronavirus 2.
. 2021 Jan 9;14(1):20.
doi: 10.1186/s13104-020-05426-2.
Prone positioning improves oxygenation and lung recruitment in patients with SARS-CoV-2 acute respiratory distress syndrome; a single centre cohort study of 20 consecutive patients
Jennifer Clarke[SUP] 1 2 [/SUP], Pierce Geoghegan[SUP] 1 2 [/SUP], Natalie McEvoy[SUP] 1 2 [/SUP], Maria Boylan[SUP] 2 [/SUP], Orna N? Choile?in[SUP] 2 [/SUP], Martin Mulligan[SUP] 2 [/SUP], Grace Hogan[SUP] 1 [/SUP], Aoife Keogh[SUP] 1 [/SUP], Oliver J McElvaney[SUP] 2 [/SUP], Ois?n F McElvaney[SUP] 2 [/SUP], John Bourke[SUP] 3 [/SUP], Bairbre McNicholas[SUP] 3 [/SUP], John G Laffey[SUP] 3 [/SUP], Noel G McElvaney[SUP] 2 [/SUP], Gerard F Curley[SUP] 4 5 [/SUP]
Affiliations
- PMID: 33422143
- DOI: 10.1186/s13104-020-05426-2
Abstract
Objective: We aimed to characterize the effects of prone positioning on respiratory mechanics and oxygenation in invasively ventilated patients with SARS-CoV-2 ARDS.
Results: This was a prospective cohort study in the Intensive Care Unit (ICU) of a tertiary referral centre. We included 20 consecutive, invasively ventilated patients with laboratory confirmed SARS-CoV-2 related ARDS who underwent prone positioning in ICU as part of their management. The main outcome was the effect of prone positioning on gas exchange and respiratory mechanics. There was a median improvement in the PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ratio of 132 in the prone position compared to the supine position (IQR 67-228). We observed lower PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] ratios in those with low (< median) baseline respiratory system static compliance, compared to those with higher (> median) static compliance (P < 0.05). There was no significant difference in respiratory system static compliance with prone positioning. Prone positioning was effective in improving oxygenation in SARS-CoV-2 ARDS. Furthermore, poor respiratory system static compliance was common and was associated with disease severity. Improvements in oxygenation were partly due to lung recruitment. Prone positioning should be considered in patients with SARS-CoV-2 ARDS.
Keywords: Adult; Prone position; Respiratory distress syndrome; Severe acute respiratory syndrome coronavirus 2.