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Prone Position after Liberation from Prolonged Mechanical Ventilation in COVID-19 Respiratory Failure

DESIGN: This is a retrospective case series describing the feasibility and tolerability of postextubation prone positioning (PEPP) and its impact on physiologic parameters in a tertiary intensive care unit during the COVID-19 pandemic. Setting and Patients. This study was conducted on patients with...

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Autores principales: Karpov, Andrei, Mitra, Anish R., Crowe, Sarah, Haljan, Gregory
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701208/
https://www.ncbi.nlm.nih.gov/pubmed/33299605
http://dx.doi.org/10.1155/2020/6688120
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author Karpov, Andrei
Mitra, Anish R.
Crowe, Sarah
Haljan, Gregory
author_facet Karpov, Andrei
Mitra, Anish R.
Crowe, Sarah
Haljan, Gregory
author_sort Karpov, Andrei
collection PubMed
description DESIGN: This is a retrospective case series describing the feasibility and tolerability of postextubation prone positioning (PEPP) and its impact on physiologic parameters in a tertiary intensive care unit during the COVID-19 pandemic. Setting and Patients. This study was conducted on patients with COVID-19 respiratory failure hospitalized in a tertiary Intensive Care Unit at Surrey Memorial Hospital during the COVID-19 pandemic. Measurements and Results. We did not find prior reports of PEPP following prolonged intubation in the literature. Four patients underwent a total of 13 PEPP sessions following liberation from prolonged mechanical ventilation. Each patient underwent a median of 3 prone sessions (IQR: 2, 4.25) lasting a median of 1.5 hours (IQR: 1.2, 2.1). PEPP sessions were associated with a reduction in median oxygen requirements, patient respiratory rate, and reintubation rate. The sessions were well tolerated by patients, nursing, and the allied health team. CONCLUSIONS: The novel practice of PEPP after liberation from prolonged mechanical ventilation in patients with COVID-19 respiratory failure is feasible and well tolerated, and may be associated with favourable clinical outcomes including improvement in oxygenation and respiratory rate and a low rate of reintubation. Larger prospective studies of PEPP are warranted.
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spelling pubmed-77012082020-12-08 Prone Position after Liberation from Prolonged Mechanical Ventilation in COVID-19 Respiratory Failure Karpov, Andrei Mitra, Anish R. Crowe, Sarah Haljan, Gregory Crit Care Res Pract Research Article DESIGN: This is a retrospective case series describing the feasibility and tolerability of postextubation prone positioning (PEPP) and its impact on physiologic parameters in a tertiary intensive care unit during the COVID-19 pandemic. Setting and Patients. This study was conducted on patients with COVID-19 respiratory failure hospitalized in a tertiary Intensive Care Unit at Surrey Memorial Hospital during the COVID-19 pandemic. Measurements and Results. We did not find prior reports of PEPP following prolonged intubation in the literature. Four patients underwent a total of 13 PEPP sessions following liberation from prolonged mechanical ventilation. Each patient underwent a median of 3 prone sessions (IQR: 2, 4.25) lasting a median of 1.5 hours (IQR: 1.2, 2.1). PEPP sessions were associated with a reduction in median oxygen requirements, patient respiratory rate, and reintubation rate. The sessions were well tolerated by patients, nursing, and the allied health team. CONCLUSIONS: The novel practice of PEPP after liberation from prolonged mechanical ventilation in patients with COVID-19 respiratory failure is feasible and well tolerated, and may be associated with favourable clinical outcomes including improvement in oxygenation and respiratory rate and a low rate of reintubation. Larger prospective studies of PEPP are warranted. Hindawi 2020-11-12 /pmc/articles/PMC7701208/ /pubmed/33299605 http://dx.doi.org/10.1155/2020/6688120 Text en Copyright © 2020 Andrei Karpov et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Karpov, Andrei
Mitra, Anish R.
Crowe, Sarah
Haljan, Gregory
Prone Position after Liberation from Prolonged Mechanical Ventilation in COVID-19 Respiratory Failure
title Prone Position after Liberation from Prolonged Mechanical Ventilation in COVID-19 Respiratory Failure
title_full Prone Position after Liberation from Prolonged Mechanical Ventilation in COVID-19 Respiratory Failure
title_fullStr Prone Position after Liberation from Prolonged Mechanical Ventilation in COVID-19 Respiratory Failure
title_full_unstemmed Prone Position after Liberation from Prolonged Mechanical Ventilation in COVID-19 Respiratory Failure
title_short Prone Position after Liberation from Prolonged Mechanical Ventilation in COVID-19 Respiratory Failure
title_sort prone position after liberation from prolonged mechanical ventilation in covid-19 respiratory failure
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701208/
https://www.ncbi.nlm.nih.gov/pubmed/33299605
http://dx.doi.org/10.1155/2020/6688120
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