• Jennifer Clarke, Pierce Geoghegan, Natalie McEvoy, Maria Boylan, Orna Ní Choileáin, Martin Mulligan, Grace Hogan, Aoife Keogh, Oliver J McElvaney, Oisín F McElvaney, John Bourke, Bairbre McNicholas, John G Laffey, Noel G McElvaney, and Gerard F Curley.
• Department of Anaesthesia and Critical Care, Royal College of Surgeons Ireland, Smurfit Building, Beaumont Hospital, Dublin 9, D09 YD60, Ireland.
• BMC Res Notes. 2021 Jan 9; 14 (1): 20.

ObjectiveWe aimed to characterize the effects of prone positioning on respiratory mechanics and oxygenation in invasively ventilated patients with SARS-CoV-2 ARDS.ResultsThis was a prospective cohort study in the Intensive Care Unit (ICU) of a tertiary referral centre. We included 20 consecutive, invasively ventilated patients with laboratory confirmed SARS-CoV-2 related ARDS who underwent prone positioning in ICU as part of their management. The main outcome was the effect of prone positioning on gas exchange and respiratory mechanics. There was a median improvement in the PaO2/FiO2 ratio of 132 in the prone position compared to the supine position (IQR 67-228). We observed lower PaO2/FiO2 ratios in those with low (< median) baseline respiratory system static compliance, compared to those with higher (> median) static compliance (P < 0.05). There was no significant difference in respiratory system static compliance with prone positioning. Prone positioning was effective in improving oxygenation in SARS-CoV-2 ARDS. Furthermore, poor respiratory system static compliance was common and was associated with disease severity. Improvements in oxygenation were partly due to lung recruitment. Prone positioning should be considered in patients with SARS-CoV-2 ARDS.

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