Comparison of prone position effectiveness with percentage of injured lung area in awake non - intubated COVID-19 patients

Abstract

Aim: Prone position plays a key role in the treatment of both non-intubated and intubated patients because COVID-19 associated respiratory failure is gas exchange abnormalities based on shunt and dead-space ventilation. In this study, we aimed to compare the effect of prone position applied in awake non-intubated COVID-19 patients with percentage of injured lung area. 
 Material and Method: 65 patients with awake, non-intubated were included in this prospective, single-center study. Percentage of injured lung area was calculated using chest computer tomography taken during diagnosis of patients. The prone position cycle was applied as 6 hours prone, 4-6 hours supine position. 
 Results: The mean of percentage of injured lung area was 25.16±13.81. When percentage of injured lung area groups were compared with the 0th, 6th, 24th and 48th hour SpO2/FIO2 ratio and respiratory frequency; while the SpO2/FIO2 ratio increased in all hours with prone position in the 0-10% and 10-30% groups, a decrease was observed in the SpO2/FIO2 ratio over time in the ≥ 30% group. 
 Conclusions: The prone position is a safe and effective application that causes improvement in SpO2/FIO2 ratio and RR in awake non-intubated COVID-19 patients with less damage to the lung. However, it should be kept in mind that as the damage to the lung increases, the expected recovery might not be possible.