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Original Article
- Pulmonary
- Awake prone positioning for COVID-19 acute hypoxemic respiratory failure in Tunisia
- Khaoula Ben Ismail, Fatma Essafi, Imen Talik, Najla Ben Slimene, Ines Sdiri, Boudour Ben Dhia, Takoua Merhbene
- Acute Crit Care. 2023;38(3):271-277. Published online August 21, 2023
- DOI: https://doi.org/10.4266/acc.2023.00591
- 5,947 View
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- 1 Web of Science
- 1 Crossref
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Abstract
PDF - Background
In this study, we explored whether awake prone position (PP) can impact prognosis of severe hypoxemia coronavirus disease 2019 (COVID-19) patients.
Methods
This was a prospective observational study of severe, critically ill adult COVID-19 patients admitted to the intensive care unit. Patients were divided into two groups: group G1, patients who benefited from a vigilant and effective PP (>4 hours minimum/24) and group G2, control group. We compared demographic, clinical, paraclinical and evolutionary data.
Results
Three hundred forty-nine patients were hospitalized during the study period, 273 met the inclusion criteria. PP was performed in 192 patients (70.3%). The two groups were comparable in terms of demographic characteristics, clinical severity and modalities of oxygenation at intensive care unit (ICU) admission. The mean PaO2/ FIO2 ratios were 141 and 128 mm Hg, respectively (P=0.07). The computed tomography scan was comparable with a critical >75% in 48.5% (G1) versus 54.2% (G2). The median duration of the daily PP session was 13±7 hours per day. The average duration of spontaneous PP days was 7 days (4–19). Use of invasive ventilation was lower in the G1 group (27% vs. 56%, P=0.002). Healthcare-associated infections were significantly lower in G1 (42.1% vs. 82%, P=0.01). Duration of total mechanical ventilation and length of ICU stay were comparable between the two groups. Mortality was significantly higher in G2 (64% vs. 28%, P=0.02).
Conclusions
Our study confirmed that awake PP can improve prognosis in COVID-19 patients. Randomized controlled trials are needed to confirm this result. -
Citations
Citations to this article as recorded by
- Awake prone positioning reduces mortality, intubation, and hospital stay in acute hypoxemic respiratory failure: a systematic review and meta-analysis of 6,164 patients
Miqdad Alsarayreh, Mostafa Hossam El Din Moawad, Husam Barham, Osamah Yousef Abdelkarim, Dina Riyadh Fahem Al-Janabi, Ibraheem M. Alkhawaldeh, Hamza A. Abdul-Hafez
BMC Anesthesiology.2026;[Epub] CrossRef
- Awake prone positioning reduces mortality, intubation, and hospital stay in acute hypoxemic respiratory failure: a systematic review and meta-analysis of 6,164 patients
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