Prone Positioning Is Safe and May Reduce the Rate of Intubation in Selected COVID-19 Patients Receiving High-Flow Nasal Oxygen Therapy.
COVID-19
acute respiratory failure
endotracheal intubation
prone positioning
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
30 Jul 2021
30 Jul 2021
Historique:
received:
03
06
2021
revised:
23
07
2021
accepted:
26
07
2021
entrez:
7
8
2021
pubmed:
8
8
2021
medline:
8
8
2021
Statut:
epublish
Résumé
Patients with COVID-19 may experience hypoxemic Acute Respiratory Failure (hARF) requiring O All consecutive unselected adult patients with bilateral lung opacities on chest X-ray receiving HFNO after admission to a SARS-CoV-2 Respiratory Intermediate Care Unit (RICU) were considered eligible. Patients who successfully passed an initial PP trial (success group) underwent PP for periods ≥ 2 h twice a day, while receiving HFNO. The study's primary endpoint was the intubation rate during the stay in the RICU. Ninety-three patients were included in the study. PP was feasible and safe in 50 (54%) patients. Sixteen (17.2%) patients received ETI and 27 (29%) escalated respiratory support, resulting in a mortality rate of 9/93 (9.7%). The length of hospital stay was 18 (6-75) days. In 41/50 (80%) of subjects who passed the trial and underwent PP, its use was associated with clinical benefit and survival without escalation of therapy. PP is feasible and safe in over 50% of COVID-19 patients receiving HFNO for hARF. Randomized trials are required to confirm that PP has the potential to reduce intubation rate.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with COVID-19 may experience hypoxemic Acute Respiratory Failure (hARF) requiring O
METHODS
METHODS
All consecutive unselected adult patients with bilateral lung opacities on chest X-ray receiving HFNO after admission to a SARS-CoV-2 Respiratory Intermediate Care Unit (RICU) were considered eligible. Patients who successfully passed an initial PP trial (success group) underwent PP for periods ≥ 2 h twice a day, while receiving HFNO. The study's primary endpoint was the intubation rate during the stay in the RICU.
RESULTS
RESULTS
Ninety-three patients were included in the study. PP was feasible and safe in 50 (54%) patients. Sixteen (17.2%) patients received ETI and 27 (29%) escalated respiratory support, resulting in a mortality rate of 9/93 (9.7%). The length of hospital stay was 18 (6-75) days. In 41/50 (80%) of subjects who passed the trial and underwent PP, its use was associated with clinical benefit and survival without escalation of therapy.
CONCLUSIONS
CONCLUSIONS
PP is feasible and safe in over 50% of COVID-19 patients receiving HFNO for hARF. Randomized trials are required to confirm that PP has the potential to reduce intubation rate.
Identifiants
pubmed: 34362185
pii: jcm10153404
doi: 10.3390/jcm10153404
pmc: PMC8348451
pii:
doi:
Types de publication
Journal Article
Langues
eng
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