Early Prone Positioning and Non-Invasive Ventilation in a Critical COVID-19 Subset. A Single Centre Experience in Southern Italy

Simioli, Francesca; Annunziata, Anna; Langella, Gerardo; Martino, Maria Cristina De; Musella, S; Fiorentino, Giuseppe

doi:10.5152/turkthoracj.2021.20158

Cited by 15 publications

(23 citation statements)

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“…Physical discomfort with the prone position was the primary factor in participant compliance, which is similar to other studies. 21,26,27 Previous publications noted limitations in maintaining the prone position 15,17,22 ; however, in this study, researchers identified specific contributing factors not previously identified such as room layout and various interruptions. The findings of this study offer additional information regarding barriers to awake self-proning in the acute care setting and considerations when implementing this intervention.…”

Section: Discussionmentioning

confidence: 74%

“…Similar to our study, adverse events such as catheter dislodgement and pressure injuries were not reported in other studies, 16,17 and some found improvement in rates of intubation and mortality. [21][22][23] Conversely, Padrão et al 24 found the prone positioning had no impact on the intubation rates in their participants. Although this was not a comparative study with a control group, we examined ICU utilization of participants.…”

Section: Discussionmentioning

confidence: 99%

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A Prospective, Descriptive Study on Awake Self-prone in Hospitalized COVID-19 Patients

et al. 2022

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Healthcare workers internationally continue to look for innovative ways to improve patient outcomes and optimize resource utilization during the coronavirus disease 2019 (COVID-19) pandemic. Proning awake, nonintubated patients has been suggested as a potential intervention in critical care. The aim of this study is to provide a multidisciplinary approach to safely perform awake self-prone positioning in the acute care setting. Design: This is a prospective, descriptive study. Method:Patients with COVID-19 were screened and enrolled within 48 hours of a positive test. After approval from the primary team, patients were provided education materials by a multidisciplinary team on the self-prone intervention. Visual cues were placed in the room. Patients were requested to maintain a diary of hours of prone positioning. Patients' baseline characteristics, admission vitals, daily oxygen requirements, and level of care were collected. Results:Of 203 patients screened, 31 were enrolled. No pressure-related injury or catheter (intravenous or urinary) displacement was identified. Eighty-one percent of patients spent less than 8 hours a day in prone positioning. Among patients enrolled, none required invasive ventilation or died. Conclusions: Awake self-proning can be performed safely in patients given a diagnosis of COVID-19 in the acute care setting with a multidisciplinary team.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

A Prospective, Descriptive Study on Awake Self-prone in Hospitalized COVID-19 Patients

et al. 2022

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“… 25 A recent study has demonstrated the substantial efficacy of the prone position. 26 In our study, awake prone was used in 96% of patients, and prone ventilation was used in all patients on mechanical ventilation except in patients with morbid obesity, acute stroke, thrombosis of limbs, and pregnancy.…”

Section: Discussionmentioning

confidence: 86%

Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit

Pandit¹,

Gagana²,

Vaity³

et al. 2021

Indian Journal of Critical Care Medicine

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A bstract Background Meta-analysis and clinical studies suggest coronavirus disease-2019 (COVID-19) patients in ICU have a high mortality rate of 30–45%, which has evolved as a function of criteria of admission and the management modalities. Materials and methods We conducted a retrospective evaluation for characteristics and outcomes in critical care set up across six months. Results 514 patients (74.3% males and 25.6% females) were evaluated. 9.72% ( n = 50) patients expired, 78% ( n = 39) were males. Mean age (years) was 57 (±14, range 64, 95% CI 55–58). 65.7% ( n = 338) were of age more than 50 years, of which 71.5% ( n = 242) were males. Males at 20% higher risk for death than women. (RR = 1.2, 95% CI 0.66–2.31, p = 0.61 NS). There was 18% less risk of mortality in female vs male with comorbidities (RR 0.82, 95% CI 0.67–1.12, p = 0.32 NS). Risk for mortality in diabetics was significantly increased by 116% vs nondiabetics. (RR 2.16, p = 0.0055, 95% CI 1.28–3.67). Highly significant risk of mortality in age group >50 years (3.13 times higher) vs age ≤50 years. (RR 3.18, 95% CI 1.71–8.64, p = 0.0003). 50.2% had moderate ARDS at admission. High flow nasal cannula was used in 47.2%. There is 5.79 times more likelihood to be on the ventilator with moderate to severe ARDS vs mild ARDS (RR = 5.79, 95% CI 3.10–11.05, p <0.0001). Risk for death was six times higher for patients on ventilator vs not on ventilator (RR = 6.08, 95% CI 3.49–10.59, p <0.0001). The mean number of days on ventilator for patients who underwent tracheostomy ( n = 49) was 14 days as compared to 6.6 days in patients who were extubated ( n = 57) ( p <0.0001). P/F ratio had negative correlation with number of days of hospitalisation (Pearson r -0.391, 95% CI -0.46– -0.31, p <0.0001). 67% less chances of mortality in patients on steroids (RR = 0.33, 95% CI 0.19–60, p = 0.0012). Mean duration of ICU stay (days) was 8 (± 5, range 29, 95% CI 7.5–8.4). Conclusions We observed that a strict adherence to the basic principles of ARDS management resulted in a lower mortality in ICU setting. How to cite this article Pandit RA, Gagana BN, Vaity C, Mulakavalupil B, Choudhary JS, Jain V, et al . Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit. Indian J Crit Care Med 2021;25(9):992–1000.

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“…Tiga penelitian melakukan perubahan posisi (diselingi posisi lain) pada masingmasing 2, 4, dan 12 jam (Kharat et al, 2021;Paternoster et al, 2020;Simioli et al, 2021). Perubahan posisi dilakukan untuk mencegah luka tekan dan nyeri sendi (Simioli et al, 2021). Hal ini sesuai dengan panduan dari ICS bahwa posisi pasien harus diubah setiap 0,5-2 jam atau lebih jika memungkinkan.…”

Section: Pembahasanunclassified

Posisi Pronasi terhadap Oksigenasi Pasien COVID-19 dengan Terapi Oksigen Non-Invasif

Noviantari

Yona

Maria

2021

JKS

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This study aims to identify evidence on the effect of pronation position on oxygenation in conscious COVID-19 patients receiving non-invasive oxygen therapy. This research method is systematic review research. Literature searches from 2020-2021 were carried out in the online databases of Science Direct, ProQuest, EBSCOhost, and PubMed. The results showed that the majority of the samples were male (69.7%) with an average age of over 50 years and a body mass index (BMI) above average (>23,9). Most of the studies (92%) showed an increase in oxygenation in patients when performed in the prone position. The duration of the pronation position varies from 35 minutes – 12 hours in 24 hours. The pronation position can improve oxygenation in most COVID-19 patients who receive non-invasive oxygen therapy. In conclusion, the pronation position is an intervention that is safe and feasible to implement in conscious COVID-19 patients but with close monitoring from trained health workers. Keywords: COVID-19, Oxygenation, Pronation Position, Non-Invasive Oxygen Therapy

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Early Prone Positioning and Non-Invasive Ventilation in a Critical COVID-19 Subset. A Single Centre Experience in Southern Italy

Cited by 15 publications

References 0 publications

A Prospective, Descriptive Study on Awake Self-prone in Hospitalized COVID-19 Patients

A Prospective, Descriptive Study on Awake Self-prone in Hospitalized COVID-19 Patients

Clinical Characteristics and Outcomes of COVID-19 Patients Hospitalized in Intensive Care Unit

Posisi Pronasi terhadap Oksigenasi Pasien COVID-19 dengan Terapi Oksigen Non-Invasif

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