Impact of prone position on outcomes of COVID-19 patients with spontaneous breathing

Mabrouk Bahloul, Sana Kharrat, Malek Hafdhi, Anis Maalla, Olfa Turki, Kamilia Chtara, Rania Ammar, Basma Suissi, Chokri Ben Hamida, Hedi Chelly, Khaiereddine Ben Mahfoudh and Mounir Bouaziz
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Mabrouk Bahloul: Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax]
Sana Kharrat: LAREQUOI - Laboratoire de recherche en Management - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines, Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax]
Malek Hafdhi: Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax]
Anis Maalla: Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax]
Olfa Turki: Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax]
Kamilia Chtara: Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax]
Rania Ammar: Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax]
Basma Suissi: Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax]
Chokri Ben Hamida: Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax]
Hedi Chelly: Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax]
Khaiereddine Ben Mahfoudh: Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax]
Mounir Bouaziz: Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax]

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Abstract: Background : In this study, we explored whether early application of the prone position (PP) can improve severe hypoxemia and respiratory failure in coronavirus disease 2019 (COVID-19) patients with spontaneous breathing. Methods : This is a prospective observational study of severe, critically ill adult COVID-19 patients admitted to the intensive care unit. All vital parameters were recorded in real time for all patients. Moreover, the results of chest computed tomography (CT), when available, were analyzed. Results : PP was applied in 21 patients who were breathing spontaneously. The application of PP was associated with a significant increase in oxygen saturation measured by pulse oximetry (SpO2) from 82%±12% to 96%±3% (P<0.001) 1 hour later. Moreover, PP was associated with a significant reduction in respiratory rate from 31±10 to 21±4 breaths/min (P<0.001). Furthermore, the number of patients who exhibited signs of respiratory distress after PP was reduced from 10 (47%) to 3 (14%) (P=0.04). Early PP application also led to a clear improvement on CT imaging. It was not, however, associated with a reduction in mortality rate or in the use of invasive mechanical ventilation (P>0.05 for both). Conclusions : Our study confirmed that the early application of PP can improve hypoxemia and tachypnea in COVID-19 patients with spontaneous breathing. Randomized controlled trials are needed to confirm the beneficial effects of PP in COVID-19 patients with spontaneous breathing.

Date: 2021-08-31
Note: View the original document on HAL open archive server: https://uvsq.hal.science/hal-04397017v1
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Published in Acute and Critical Care, 2021, 36 (3), pp.208-214. ⟨10.4266/acc.2021.00500⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-04397017

DOI: 10.4266/acc.2021.00500

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