• Respiratory care · Jun 2023

    Hemodynamic Effects of Awake Prone Positioning With COVID-19 Acute Respiratory Failure.

    • Matthias Jacquet-Lagrèze, Zakaria Riad, Philippe Portran, Delphine Chesnel, Rémi Schweizer, Arnaud Ferarris, Louis Jacquemet, Martin Ruste, and Jean-Luc Fellahi.
    • Service d'anesthésie-réanimation, Hôpital cardiologique Louis Pradel, Hospices Civils de Lyon, Bron, France; Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France; and CarMeN Laboratory, Inserm UMR 1060, Université Claude Bernard Lyon 1, Lyon, France. matthias.jacquet-lagreze@chu-lyon.fr.
    • Respir Care. 2023 Jun 1; 68 (6): 713720713-720.

    IntroductionAwake prone positioning (PP) reduces need for intubation for patients with COVID-19 with acute respiratory failure. We investigated the hemodynamic effects of awake PP in non-ventilated subjects with COVID-19 acute respiratory failure.MethodsWe conducted a single-center prospective cohort study. Adult hypoxemic subjects with COVID-19 not requiring invasive mechanical ventilation receiving at least one PP session were included. Hemodynamic assessment was done with transthoracic echocardiography before, during, and after a PP session.ResultsTwenty-six subjects were included. We observed a significant and reversible increase in cardiac index (CI) during PP compared to supine position (SP): 3.0 ± 0.8 L/min/m2 in PP, 2.5 ± 0.6 L/min/m2 before PP (SP1), and 2.6 ± 0.5 L/min/m2 after PP (SP2, P < .001). A significant improvement in right ventricular (RV) systolic function was also evidenced during PP: The RV fractional area change was 36 ± 10% in SP1, 46 ± 10% during PP, and 35 ± 8% in SP2 (P < .001). There was no significant difference in PaO2 /FIO2 and breathing frequency.ConclusionCI and RV systolic function are improved by awake PP in non-ventilated subjects with COVID-19 with acute respiratory failure.Copyright © 2023 by Daedalus Enterprises.

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