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Journal of critical care · Dec 2020
Rapid implementation of a mobile prone team during the COVID-19 pandemic.
- Briana Short, Madhavi Parekh, Patrick Ryan, Maggie Chiu, Cynthia Fine, Peter Scala, Shirah Moses, Emily Jackson, Daniel Brodie, and Natalie H Yip.
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University Vagelos College of Physicians & Surgeons/NewYork-Presbyterian Hospital, New York, NY, USA. Electronic address: bs2886@cumc.columbia.edu.
- J Crit Care. 2020 Dec 1; 60: 230-234.
PurposeThe coronavirus disease 2019 (COVID-19) is associated with high rates of acute respiratory distress syndrome (ARDS). Prone positioning improves mortality in moderate-to-severe ARDS. Strategies to increase prone positioning under crisis conditions are needed.Material And MethodsWe describe the development of a mobile prone team during the height of the crisis in New York City and describe characteristics and outcomes of mechanically ventilated patients who received prone positioning between April 2, 2020 and April 30, 2020.ResultsNinety patients underwent prone positioning for moderate-to-severe ARDS. Sixty-six patients (73.3%) were men, with a median age of 64 years (IQR 53-71), and the median PaO2:FiO2 ratio was 107 (IQR 85-140) prior to prone positioning. Patients required an average of 3 ± 2.2 prone sessions and the median time of each prone session was 19 h (IQR 17.5-20.75). By the end of the study period, proning was discontinued in sixty-seven (65.1%) cases due to clinical improvement, twenty (19.4%) cases due to lack of clinical improvement, six (5.8%) cases for clinical worsening, and ten (9.7%) cases due to a contraindication.ConclusionThe rapid development of a mobile prone team safely provided prone positioning to a large number of COVID-19 patients with moderate-to-severe ARDS.Copyright © 2020 Elsevier Inc. All rights reserved.
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