2021, Number 3
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Med Crit 2021; 35 (3)
''First line guidelines'' for the care of patients with COVID-19. Prone position in awake non-intubated patients with ARDS
Deloya-Tomas E, Pérez-Nieto OR, Zamarrón-López EI, Soriano-Orozco R, Meneses-Olguín C, Guerrero-Gutiérrez MA, Sánchez-Díaz JS, Garza-de MA, Monares-Zepeda E
Language: Spanish
References: 16
Page: 157-161
PDF size: 205.08 Kb.
ABSTRACT
The use of the prone position (PP) has been proposed for awake, non-intubated patients hospitalized for pneumonia and respiratory failure. This therapy is not new, it has been described for two decades. However, observational and some prospective clinical studies have been conducted with a limited number of patients, and a significant improvement in increased arterial partial pressure of oxygen (paO
2), decreased respiratory rate, and decreased respiratory failure has been observed. .The usefulness of PP in awake patients remains controversial when trying to show that it could significantly prevent intubation.
REFERENCES
Apigo M. Development of a work of breathing scale and monitoring need of intubation in COVID-19 pneumonia. Crit Care. 2020;24:477. Available in: https://doi.org/10.1186/s13054-020-03176-y.
Valter C. Response to the prone position in spontaneously breathing patients with hypoxemic respiratory failure. Acta Anaesthesiol Scand. 2003;47(4):416-418. Available in: https://doi.org/10.1034/j.1399- 6576.2003.00088.x.
Bower G. Protocol for awake prone positioning in COVID-19 patients: to do it earlier, easier, and longer. Crit Care. 2020;24(1):371. Available in: https://doi.org/10.1186/s13054-020-03096-x.
Guérin C. Prone positioning acute respiratory distress syndrome patients. Ann Transl Med. 2017;5(14):289. Available in: https://doi:10.21037/atm.2017.06.63.
Scaravilli V. Prone positioning improves oxygenation in spontaneously breathing nonintubated patients with hypoxemic acute respiratory failure: a retrospective study. J Crit Care. 2015;30(6):1390-1394. Available in: https://doi.org/10.1016/j.jcrc.2015.07.008.
Ding L. Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS: a multi-center prospective cohort study. Crit Care. 2020;24(1):28. Available in: https://doi.org/10.1186/s13054-020-2738-5.
Pérez-Nieto OR. Prone positioning combined with high-flow nasal cannula in severe noninfectious ARDS. Crit Care. 2020;24(1):114. Available in: https://doi.org/10.1186/s13054-020-2821-y.
Slessarev M. Patient self-proning with high-flow nasal cannula improves oxygenation in COVID-19 pneumonia. Can J Anaesth. 2020;67(9):1288-1290. Available in: https://doi.org/10.1007/s12630-020-01661-0.
Sun Q. Lower mortality of COVID-19 by early recognition and intervention: experience from Jiangsu province. Ann Intensive Care. 2020;10(1):33. Available in: https://doi.org/10.1186/s13613-020-00650-2.
Caputo N. Early self-proning in awake, non-intubated patients in the emergency department: a single ED's experience during the COVID-19 pandemic. Academic emergency medicine. Academic Emergency Medicine. 2020;27(5):375-378. Available in: https://doi.org/10.1111/acem.13994.
Jagan N. The POSITIONED study: prone positioning in nonventilated coronavirus disease 2019 patients. A retrospective analysis. Crit Care Explor. 2020;2(10):e0229. Available in: https://doi.org/10.1097/CCE.0000000000000229.
Thompson A. Prone positioning in awake, nonintubated patients with COVID-19 hypoxemic respiratory failure. JAMA Intern Med. 2020;e203030. Advance online publication. Available in: https://doi.org/10.1001/jamainternmed.2020.3030.
Ferrando C. Awake prone positioning does not reduce the risk of intubation in COVID-19 treated with high-flow nasal oxygen therapy: a multicenter, adjusted cohort study. Crit Care. 2020;24:597. Available in: https://doi.org/10.1186/s13054-020-03314-6.
Sodhi K. Awake proning: awake proning: current evidence and practical considerations. Indian J Crit Care Med. 2020;24(12):1236-1241. doi: 10.5005/jp-journals-10071-23684. Available in: doi: https://dx.doi.org/10.5005%2Fjp-journals-10071-23684.
Sryma P. Reinventing the wheel in ARDS: awake proning in COVID-19. Archivos de Bronconeumología. 2020;56(11):747-749. Available in: https://doi.org/10.1016/j.arbres.2020.06.002.
Perez-Nieto OR, Escarraman-Martinez D, Guerrero-Gutierrez MA, et al. Awake prone positioning and oxygen therapy in patients with COVID-19: The APRONOX study. medRxiv. 2021.01.27.21250631; Available in: https://doi.org/10.1101/2021.01.27.21250631.