|dc.identifier.citation||Joseph Barker, Daniel Pan , David Koeckerling, Alexander James Baldwin, Raha West. Effect of serial awake prone positioning on oxygenation in patients admitted to intensive care with COVID-19Postgrad Med J 2021;0:1–5. doi:10.1136/postgradmedj-2020-139631||en
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.||en
|dc.description.abstract||Introduction Awake prone positioning (APP)
might benefit patients with COVID-19 by improving
oxygenation, but it is unknown whether this
improvement can be sustained with serial proning
Methods We conducted a retrospective review of
adults with COVID-19 admitted to one intensive care
unit, in those who underwent APP and controls. Patients
in both groups had type 1 respiratory failure requiring
oxygen (but not initially intubated), confirmed SARS CoV-2 PCR by nasopharyngeal swab and findings
of multifocal ground-glass opacities on imaging. For
the APP group, serial SpO2
recorded after each proning episode.
Results Of 77 patients admitted, 50 (65%) were
excluded because they had already been intubated.
Another 7 (9%) had undergone APP prior to admission.
Of the remaining 20, 10 underwent APP and 10
were controls. Patients in both groups had similar
demographics, subsequent intubation and survival. Of
those who underwent APP, SpO2
was most likely to
increase after the first episode (before median: 152, IQR
135–185; after: median 192, IQR 156–234, p=0.04).
Half of participants (5) in the APP group were unable to
tolerate more than two APP episodes.
Conclusions Most patients with COVID-19 admitted
to the intensive care are not suitable for APP. Of
those who are, many cannot tolerate more than two
episodes. Improvements in SpO2
APP are transient and most likely in the first episode.
Our findings may explain why other studies have failed
to show improvements in mortality from APP despite
improvements in oxygenation.||en
|dc.subject||Awake prone positioning (APP)||en
|dc.title||Effect of serial awake prone positioning on oxygenation in patients admitted to intensive care with COVID-19||en