Impact of prone position on outcomes of COVID-19 patients with spontaneous breathing - Université de Versailles Saint-Quentin-en-Yvelines Access content directly
Journal Articles Acute and Critical Care Year : 2021

Impact of prone position on outcomes of COVID-19 patients with spontaneous breathing

Malek Hafdhi
  • Function : Author
Anis Maalla
  • Function : Author
Olfa Turki
  • Function : Author
Kamilia Chtara
  • Function : Author
Rania Ammar
  • Function : Author
Basma Suissi
  • Function : Author
Chokri Ben Hamida
  • Function : Author
Hedi Chelly
  • Function : Author
Khaiereddine Ben Mahfoudh
  • Function : Author
Mounir Bouaziz
  • Function : Author

Abstract

Background: In this study, we explored whether early application of the prone position (PP) can improve severe hypoxemia and respiratory failure in coronavirus disease 2019 (COVID-19) patients with spontaneous breathing.Methods: This is a prospective observational study of severe, critically ill adult COVID-19 patients admitted to the intensive care unit. All vital parameters were recorded in real time for all patients. Moreover, the results of chest computed tomography (CT), when available, were analyzed.Results: PP was applied in 21 patients who were breathing spontaneously. The application of PP was associated with a significant increase in oxygen saturation measured by pulse oximetry (SpO2) from 82%±12% to 96%±3% (P<0.001) 1 hour later. Moreover, PP was associated with a significant reduction in respiratory rate from 31±10 to 21±4 breaths/min (P<0.001). Furthermore, the number of patients who exhibited signs of respiratory distress after PP was reduced from 10 (47%) to 3 (14%) (P=0.04). Early PP application also led to a clear improvement on CT imaging. It was not, however, associated with a reduction in mortality rate or in the use of invasive mechanical ventilation (P>0.05 for both).Conclusions: Our study confirmed that the early application of PP can improve hypoxemia and tachypnea in COVID-19 patients with spontaneous breathing. Randomized controlled trials are needed to confirm the beneficial effects of PP in COVID-19 patients with spontaneous breathing.

Dates and versions

hal-04397017 , version 1 (16-01-2024)

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Mabrouk Bahloul, Sana Kharrat, Malek Hafdhi, Anis Maalla, Olfa Turki, et al.. Impact of prone position on outcomes of COVID-19 patients with spontaneous breathing. Acute and Critical Care, 2021, 36 (3), pp.208-214. ⟨10.4266/acc.2021.00500⟩. ⟨hal-04397017⟩
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