Effectiveness of prone position in spontaneously breathing patients with COVID-19: A prospective cohort study

Brigitta Fazzini; Alex J Fowler; Parjam Zolfaghari

doi:10.1177/1751143721996542

Effectiveness of prone position in spontaneously breathing patients with COVID-19: A prospective cohort study

J Intensive Care Soc. 2022 Aug;23(3):362-365. doi: 10.1177/1751143721996542. Epub 2021 Feb 18.

Authors

Brigitta Fazzini^{1

2}, Alex J Fowler^{1

3}, Parjam Zolfaghari^{1

3}

Affiliations

¹ Adult Critical Care Unit, The Royal London Hospital, London, UK.
² Critical Care Outreach Team, The Royal London Hospital, London, UK.
³ Queen Mary University of London, William Harvey Research Institute, London, UK.

Abstract

We present a single centre study describing the effect of awake prone position (PP) on oxygenation and clinical outcomes in spontaneously breathing patients with novel coronavirus disease (COVID-19). Between 1st March and 30th April 2020, forty eight of 138 patients managed outside of the critical care unit with facemask oxygen, high flow nasal oxygen (HFNO) or continuous positive airway pressure (CPAP), underwent PP. Prone position was associated with significant improvement in oxygenation, lower ICU admission, tracheal intubation, and shorter ICU length of stay. Lack of response to PP may be an indicator of treatment failure, requiring early escalation.

Keywords: Novel coronavirus disease 2019 (COVID-19); Viral pneumonia; acute respiratory distress syndrome (ARDS); noninvasive ventilation; prone positioning (PP).