Effect of proning in patients with COVID-19 acute hypoxemic respiratory failure receiving noninvasive oxygen therapy
Background: Novel coronavirus (SARS-CoV-2) infection is associated with hypoxemic respiratory failure. Mechanical ventilation (MV) is reported to have high mortality in SARS-CoV-2 acute respiratory distress syndrome. We aimed to investigate whether awake prone positioning (PP) can improve oxygenatio...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Lung India |
| Subjects: | |
| Online Access: | http://www.lungindia.com/article.asp?issn=0970-2113;year=2021;volume=38;issue=7;spage=6;epage=10;aulast=Sryma |
| _version_ | 1818855753473064960 |
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| author | P B Sryma Saurabh Mittal Anant Mohan Karan Madan Pawan Tiwari Sushma Bhatnagar Anjan Trikha Ravi Dosi Shweta Bhopale Renjith Viswanath Vijay Hadda Randeep Guleria Bhvya Baldwa |
| author_facet | P B Sryma Saurabh Mittal Anant Mohan Karan Madan Pawan Tiwari Sushma Bhatnagar Anjan Trikha Ravi Dosi Shweta Bhopale Renjith Viswanath Vijay Hadda Randeep Guleria Bhvya Baldwa |
| author_sort | P B Sryma |
| collection | DOAJ |
| description | Background: Novel coronavirus (SARS-CoV-2) infection is associated with hypoxemic respiratory failure. Mechanical ventilation (MV) is reported to have high mortality in SARS-CoV-2 acute respiratory distress syndrome. We aimed to investigate whether awake prone positioning (PP) can improve oxygenation and prevent intubation when employed early. Methods: This prospective interventional study included proven coronavirus disease 2019 (COVID-19) patients with room air saturation 93% or less. The primary outcome was the rate of intubation between the two groups. The secondary outcomes included ROX index (SpO2/FiO2%/respiratory rate, breaths/min) at 30 min following the intervention, ROX index at 12 h, time to recovery of hypoxemia, and mortality. Results: A total of 45 subjects were included (30 cases and 15 controls) with a mean (standard deviation [SD]) age of 53.1 (11.0) years. The age, comorbidities, and baseline ROX index were similar between the two groups. The median duration of PP achieved was 7.5 h on the 1st day. The need for MV was higher in the control group (5/15; 33.3%) versus prone group (2/30; 6.7%). At 30 min, there was a statistically significant improvement in the mean (SD) ROX index of cases compared with that of the controls (10.7 [3.8] vs. 6.7 [2.6], P < 0.001). No significant adverse effects related to intervention were noted. Conclusion: Awake PP is associated with significant improvement in oxygenation and may reduce the need for MV in subjects with COVID-19. |
| first_indexed | 2024-12-19T08:13:37Z |
| format | Article |
| id | doaj.art-fa7f36b7162140bfbae43c4931e1bb9c |
| institution | Directory Open Access Journal |
| issn | 0970-2113 0974-598X |
| language | English |
| last_indexed | 2024-12-19T08:13:37Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Lung India |
| spelling | doaj.art-fa7f36b7162140bfbae43c4931e1bb9c2022-12-21T20:29:34ZengWolters Kluwer Medknow PublicationsLung India0970-21130974-598X2021-01-0138761010.4103/lungindia.lungindia_794_20Effect of proning in patients with COVID-19 acute hypoxemic respiratory failure receiving noninvasive oxygen therapyP B SrymaSaurabh MittalAnant MohanKaran MadanPawan TiwariSushma BhatnagarAnjan TrikhaRavi DosiShweta BhopaleRenjith ViswanathVijay HaddaRandeep GuleriaBhvya BaldwaBackground: Novel coronavirus (SARS-CoV-2) infection is associated with hypoxemic respiratory failure. Mechanical ventilation (MV) is reported to have high mortality in SARS-CoV-2 acute respiratory distress syndrome. We aimed to investigate whether awake prone positioning (PP) can improve oxygenation and prevent intubation when employed early. Methods: This prospective interventional study included proven coronavirus disease 2019 (COVID-19) patients with room air saturation 93% or less. The primary outcome was the rate of intubation between the two groups. The secondary outcomes included ROX index (SpO2/FiO2%/respiratory rate, breaths/min) at 30 min following the intervention, ROX index at 12 h, time to recovery of hypoxemia, and mortality. Results: A total of 45 subjects were included (30 cases and 15 controls) with a mean (standard deviation [SD]) age of 53.1 (11.0) years. The age, comorbidities, and baseline ROX index were similar between the two groups. The median duration of PP achieved was 7.5 h on the 1st day. The need for MV was higher in the control group (5/15; 33.3%) versus prone group (2/30; 6.7%). At 30 min, there was a statistically significant improvement in the mean (SD) ROX index of cases compared with that of the controls (10.7 [3.8] vs. 6.7 [2.6], P < 0.001). No significant adverse effects related to intervention were noted. Conclusion: Awake PP is associated with significant improvement in oxygenation and may reduce the need for MV in subjects with COVID-19.http://www.lungindia.com/article.asp?issn=0970-2113;year=2021;volume=38;issue=7;spage=6;epage=10;aulast=Srymaawake proningcovid-19prone positioningsars-cov-2 |
| spellingShingle | P B Sryma Saurabh Mittal Anant Mohan Karan Madan Pawan Tiwari Sushma Bhatnagar Anjan Trikha Ravi Dosi Shweta Bhopale Renjith Viswanath Vijay Hadda Randeep Guleria Bhvya Baldwa Effect of proning in patients with COVID-19 acute hypoxemic respiratory failure receiving noninvasive oxygen therapy Lung India awake proning covid-19 prone positioning sars-cov-2 |
| title | Effect of proning in patients with COVID-19 acute hypoxemic respiratory failure receiving noninvasive oxygen therapy |
| title_full | Effect of proning in patients with COVID-19 acute hypoxemic respiratory failure receiving noninvasive oxygen therapy |
| title_fullStr | Effect of proning in patients with COVID-19 acute hypoxemic respiratory failure receiving noninvasive oxygen therapy |
| title_full_unstemmed | Effect of proning in patients with COVID-19 acute hypoxemic respiratory failure receiving noninvasive oxygen therapy |
| title_short | Effect of proning in patients with COVID-19 acute hypoxemic respiratory failure receiving noninvasive oxygen therapy |
| title_sort | effect of proning in patients with covid 19 acute hypoxemic respiratory failure receiving noninvasive oxygen therapy |
| topic | awake proning covid-19 prone positioning sars-cov-2 |
| url | http://www.lungindia.com/article.asp?issn=0970-2113;year=2021;volume=38;issue=7;spage=6;epage=10;aulast=Sryma |
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