Early conscious prone positioning in patients with COVID-19 receiving continuous positive airway pressure: a retrospective analysis.
Stuart Winearls,Ema L Swingwood,Charlotte L Hardaker,Amy M Smith,Fraser M Easton,Katherine J Millington,Rebecca S Hall,Ann Smith,Katrina J Curtis +8 more
TLDR
From the experience in a dedicated COVID-19 respiratory high care unit, PP alongside CPAP therapy was feasible, tolerated, safe and improved oxygenation, and the use of conscious PP in ARDS warrants further investigation in randomised controlled trials.Abstract:
The global pandemic of COVID-19 has challenged the management of hypoxaemic respiratory failure and strained intensive care unit resources. While prone positioning (PP) is an established therapy in mechanically ventilated patients with acute respiratory distress syndrome (ARDS), its role in conscious patients is less well defined. We retrospectively reviewed our experience of implementing early PP in a cohort of 24 patients with acute hypoxaemic respiratory failure due to COVID-19 who required support with continuous positive airway pressure (CPAP). The use of PP alongside CPAP significantly increased both the ROX index and arterial oxygen pressure:fractional inspired oxygen (PaO2:FiO2) ratio from baseline values (ROX index: 7.0±2.5 baseline vs 11.4±3.7 CPAP+PP, pread more
Citations
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Management of hospitalised adults with coronavirus disease 2019 (COVID-19): a European Respiratory Society living guideline.
James D. Chalmers,Megan Crichton,Pieter Goeminne,Bin Cao,Marc Humbert,Michal Shteinberg,Katerina M. Antoniou,Charlotte Suppli Ulrik,Helen Parks,Chen Wang,Thomas Vandendriessche,Jieming Qu,Jieming Qu,Daiana Stolz,Christopher E. Brightling,Tobias Welte,Stefano Aliberti,Anita K. Simonds,Thomy Tonia,Nicolas Roche +19 more
TL;DR: In this paper, a task force from the European Respiratory Society and endorsed by the Chinese Thoracic Society identified priority interventions for the initial version of this "living guideline" using PICO (population, intervention, comparator, outcome) format.
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Prone positioning for patients with hypoxic respiratory failure related to COVID-19.
TL;DR: Pneumonia is the most common reason for admission to hospital among patients with coronavirus disease 2019 (COVID-19), and many such patients will require supplemental oxygen therapy.
Journal ArticleDOI
Prone Positioning of Nonintubated Patients With Coronavirus Disease 2019-A Systematic Review and Meta-Analysis
Mallikarjuna Ponnapa Reddy,Ashwin Subramaniam,Afsana Afroz,Baki Billah,Zheng Jie Lim,Alexandr Zubarev,Gabriel Blecher,Ravindranath Tiruvoipati,Kollengode Ramanathan,Suei Nee Wong,Daniel Brodie,Eddy Fan,Kiran Shekar,Kiran Shekar +13 more
TL;DR: A systematic review and meta-analysis evaluated the impact of prone positioning on oxygenation and clinical outcomes in non-intubated patients with coronavirus diseases 2019-related hypoxemic respiratory failure.
Journal ArticleDOI
Non-invasive respiratory support in the management of acute COVID-19 pneumonia: considerations for clinical practice and priorities for research
TL;DR: In this paper , the authors identified two randomised controlled trials and 83 observational studies, compromising 13 931 patients, that examined the effects of NIRS modalities (high-flow nasal oxygen, continuous positive airway pressure, and bilevel positive airflow pressure) on patients with COVID-19-associated acute respiratory failure.
Journal ArticleDOI
Mortality and clinical outcomes in patients with COVID-19 pneumonia treated with non-invasive respiratory support: A rapid review.
Dejan Radovanovic,Silvia Coppola,Elisa Franceschi,Fabrizio Gervasoni,Eleonora Duscio,Davide Chiumello,Pierachille Santus +6 more
TL;DR: In this paper, a review was conducted to analyze mortality and intubation rates in COVID-19 patients treated with NIV/CPAP, which showed that NIV and CPAP were equally and frequently applied in patients with COVID19 pneumonia, but associated with high mortality.
References
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Journal ArticleDOI
An Expanded Definition of the Adult Respiratory Distress Syndrome
TL;DR: An expanded definition of ARDS is proposed that takes into account new knowledge about adult respiratory distress syndrome and its clinical features, physiologic disturbances, prognosis, and pathologic findings.
Journal ArticleDOI
Comparison of the Spo2/Fio2 Ratio and the Pao2/Fio2 Ratio in Patients With Acute Lung Injury or ARDS
Todd W. Rice,Arthur P. Wheeler,Gordon R. Bernard,Douglas Hayden,David A. Schoenfeld,Lorraine B. Ware +5 more
TL;DR: It is hypothesized that the pulse oximetric saturation (Spo(2))/Fio(2) (S/F) ratio can be substituted for the P/F ratio in assessing the oxygenation criterion of ALI and ARDS.
Journal ArticleDOI
Prone Position for Acute Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis
Laveena Munshi,Lorenzo Del Sorbo,Neill K. J. Adhikari,Carol L. Hodgson,Hannah Wunsch,Maureen O. Meade,Elizabeth Uleryk,Jordi Mancebo,Antonio Pesenti,V. Marco Ranieri,Eddy Fan +10 more
TL;DR: Prone positioning is likely to reduce mortality among patients with severe ARDS when applied for at least 12 hours daily, and was associated with higher rates of endotracheal tube obstruction and pressure sores.
Journal ArticleDOI
Feasibility and physiological effects of prone positioning in non-intubated patients with acute respiratory failure due to COVID-19 (PRON-COVID): a prospective cohort study.
Anna Coppo,Giacomo Bellani,Dario Winterton,Michela Di Pierro,Alessandro Soria,Paola Faverio,Matteo Cairo,S. Mori,Grazia Messinesi,Ernesto Contro,Paolo Bonfanti,Annalisa Benini,Maria Grazia Valsecchi,Laura Antolini,Giuseppe Foti +14 more
TL;DR: Prone positioning was feasible and effective in rapidly ameliorating blood oxygenation in awake patients with COVID-19-related pneumonia requiring oxygen supplementation and the effect was maintained after resupination in half of the patients.
Journal ArticleDOI
Use of Prone Positioning in Nonintubated Patients With COVID-19 and Hypoxemic Acute Respiratory Failure.
Xavier Elharrar,Youssef Trigui,Anne Marie Dols,François Touchon,Stéphanie Martinez,Eloi Prud'Homme,Laurent Papazian +6 more
TL;DR: This case series describes the proportion of awake, nonintubated inpatients with COVID-19 and hypoxemic respiratory failure requiring oxygen supplementation whose Pa o 2 increased ≥20% with prone positioning, and their respiratory status after resuming supine positioning.
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