COVID-19 Lessons Learned: Prone Positioning With and Without Invasive Ventilation

Prone positioning (PP) has been used extensively for patients requiring invasive mechanical ventilation for hypoxemic respiratory failure during the COVID-19 pandemic. Evidence suggests that PP was beneficial during the pandemic, as it improves oxygenation and might improve chances of survival, espe...

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Bibliographic Details
Published in:Respiratory care 2022-08, Vol.67 (8), p.1011-1021
Main Authors: Scott, J Brady, Weiss, Tyler T, Li, Jie
Format: Article
Language:English
Subjects:
Acute respiratory distress syndrome
Care and treatment
COVID-19
Critical care medicine
Humans
Methods
Noninvasive Ventilation - adverse effects
Oxygen therapy
Pandemics
Patient outcomes
Patient Positioning - methods
Patients
Positioning
Prone Position - physiology
Respiratory Insufficiency - etiology
Respiratory Insufficiency - therapy
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Summary:Prone positioning (PP) has been used extensively for patients requiring invasive mechanical ventilation for hypoxemic respiratory failure during the COVID-19 pandemic. Evidence suggests that PP was beneficial during the pandemic, as it improves oxygenation and might improve chances of survival, especially in those with a continuum of positive oxygenation responses to the procedure. Additionally, the pandemic drove innovation regarding PP, as it brought attention to awake PP (APP) and the value of an interdisciplinary team approach to PP during a pandemic. APP appears to be safe and effective at improving oxygenation; APP may also reduce the need for intubation in patients requiring advanced respiratory support like high-flow nasal cannula or noninvasive ventilation. Teams specifically assembled for PP during a pandemic also appear useful and can provide needed assistance to bedside clinicians in the time of crisis. Complications associated with PP can be mitigated, and a multidisciplinary approach to reduce the incidence of complications is recommended.
ISSN:0020-1324
1943-3654
DOI:10.4187/respcare.10141