• P B Sryma, Saurabh Mittal, Anant Mohan, Karan Madan, Pawan Tiwari, Sushma Bhatnagar, Anjan Trikha, Ravi Dosi, Shweta Bhopale, Renjith Viswanath, Vijay Hadda, Randeep Guleria, and Bhvya Baldwa.
• Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.
• Lung India. 2021 Mar 1; 38 (Supplement): S6-S10.

BackgroundNovel coronavirus (SARS-CoV-2) infection is associated with hypoxemic respiratory failure. Mechanical ventilation (MV) is reported to have high mortality in SARS-CoV-2 acute respiratory distress syndrome. We aimed to investigate whether awake prone positioning (PP) can improve oxygenation and prevent intubation when employed early.MethodsThis prospective interventional study included proven coronavirus disease 2019 (COVID-19) patients with room air saturation 93% or less. The primary outcome was the rate of intubation between the two groups. The secondary outcomes included ROX index (SpO2/FiO2%/respiratory rate, breaths/min) at 30 min following the intervention, ROX index at 12 h, time to recovery of hypoxemia, and mortality.ResultsA total of 45 subjects were included (30 cases and 15 controls) with a mean (standard deviation [SD]) age of 53.1 (11.0) years. The age, comorbidities, and baseline ROX index were similar between the two groups. The median duration of PP achieved was 7.5 h on the 1st day. The need for MV was higher in the control group (5/15; 33.3%) versus prone group (2/30; 6.7%). At 30 min, there was a statistically significant improvement in the mean (SD) ROX index of cases compared with that of the controls (10.7 [3.8] vs. 6.7 [2.6], P < 0.001). No significant adverse effects related to intervention were noted.ConclusionAwake PP is associated with significant improvement in oxygenation and may reduce the need for MV in subjects with COVID-19.

4 keywords...

hide…