Sustained oxygenation improvement after first prone positioning is associated with liberation from mechanical ventilation and mortality in critically ill COVID-19 patients: a cohort study.
COVID19
ICU
Prone positioning
Ventilatory free days
Journal
Annals of intensive care
ISSN: 2110-5820
Titre abrégé: Ann Intensive Care
Pays: Germany
ID NLM: 101562873
Informations de publication
Date de publication:
26 Apr 2021
26 Apr 2021
Historique:
received:
22
12
2020
accepted:
10
04
2021
entrez:
26
4
2021
pubmed:
27
4
2021
medline:
27
4
2021
Statut:
epublish
Résumé
Prone positioning (PP) has been used to improve oxygenation in patients affected by the SARS-CoV-2 disease (COVID-19). Several mechanisms, including lung recruitment and better lung ventilation/perfusion matching, make a relevant rational for using PP. However, not all patients maintain the oxygenation improvement after returning to supine position. Nevertheless, no evidence exists that a sustained oxygenation response after PP is associated to outcome in mechanically ventilated COVID-19 patients. We analyzed data from 191 patients affected by COVID-19-related acute respiratory distress syndrome undergoing PP for clinical reasons. Clinical history, severity scores and respiratory mechanics were analyzed. Patients were classified as responders (≥ median PaO The median PaO Sustained oxygenation improvement after first PP session is independently associated to improved survival and reduced duration of mechanical ventilation in critically ill COVID-19 patients.
Sections du résumé
BACKGROUND
BACKGROUND
Prone positioning (PP) has been used to improve oxygenation in patients affected by the SARS-CoV-2 disease (COVID-19). Several mechanisms, including lung recruitment and better lung ventilation/perfusion matching, make a relevant rational for using PP. However, not all patients maintain the oxygenation improvement after returning to supine position. Nevertheless, no evidence exists that a sustained oxygenation response after PP is associated to outcome in mechanically ventilated COVID-19 patients. We analyzed data from 191 patients affected by COVID-19-related acute respiratory distress syndrome undergoing PP for clinical reasons. Clinical history, severity scores and respiratory mechanics were analyzed. Patients were classified as responders (≥ median PaO
RESULTS
RESULTS
The median PaO
CONCLUSIONS
CONCLUSIONS
Sustained oxygenation improvement after first PP session is independently associated to improved survival and reduced duration of mechanical ventilation in critically ill COVID-19 patients.
Identifiants
pubmed: 33900484
doi: 10.1186/s13613-021-00853-1
pii: 10.1186/s13613-021-00853-1
pmc: PMC8072095
doi:
Types de publication
Journal Article
Langues
eng
Pagination
63Investigateurs
Marco Tartaglione
(M)
Valentina Chiarini
(V)
Virginia Buldini
(V)
Carlo Coniglio
(C)
Federico Moro
(F)
Clara Barbalace
(C)
Mario Citino
(M)
Nicola Cilloni
(N)
Lorenzo Giuntoli
(L)
Angela Bellocchio
(A)
Emanuele Matteo
(E)
Giacinto Pizzilli
(G)
Antonio Siniscalchi
(A)
Chiara Tartivita
(C)
Francesco Matteo
(F)
Annalisa Marchio
(A)
Igor Bacchilega
(I)
Laura Bernabé
(L)
Sonia Guarino
(S)
Elena Mosconi
(E)
Luca Bissoni
(L)
Lorenzo Viola
(L)
Tommaso Meconi
(T)
Vittorio Pavoni
(V)
Aline Pagni
(A)
Patrizia Pompa Cleta
(P)
Marco Cavagnino
(M)
Anna Malfatto
(A)
Angelina Adduci
(A)
Silvia Pareschi
(S)
Gabriele Melegari
(G)
Jessica Maccieri
(J)
Elisa Marinangeli
(E)
Fabrizio Racca
(F)
Marco Verri
(M)
Giulia Falò
(G)
Elisabetta Marangoni
(E)
Francesco Boni
(F)
Giulia Felloni
(G)
Federico Domenico Baccarini
(FD)
Marina Terzitta
(M)
Stefano Maitan
(S)
Filippo Becherucci
(F)
Maddalena Parise
(M)
Francesca Masoni
(F)
Michele Imbriani
(M)
Paolo Orlandi
(P)
Francesco Monetti
(F)
Giorgia Dalpiaz
(G)
Rita Golfieri
(R)
Federica Ciccarese
(F)
Antonio Poerio
(A)
Francesco Muratore
(F)
Fabio Ferrari
(F)
Martina Mughetti
(M)
Loredana Franchini
(L)
Ersenad Neziri
(E)
Marco Miceli
(M)
Maria Teresa Minguzzi
(MT)
Lorenzo Mellini
(L)
Sara Piciucchi
(S)
Maurizio Bartolucci
(M)
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