• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Chronic Disease

Prone positioning in non-intubated COVID-19 patients with acute respiratory failure may transiently improve blood oxygenation levels

byMichael PratteandArnav Agarwal, MD
June 29, 2020
in Chronic Disease, Emergency, Infectious Disease, Pulmonology
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Non-intubated patients with COVID-19-related pneumonia had substantial, yet non-sustained, improvements in their PaO2/FiO2 ratio by over 50% after 10 minutes of prone positioning.

2. Patients who had sustained responses to prone positioning were generally prone positioned earlier and had higher inflammatory responses; however, rates of intubation between responders and non-responders were comparable.

Evidence Rating Level: 2 (Good)

Study Rundown: There has been a substantial increase in the burden of acute respiratory failure requiring intensive care and invasive ventilation among hospitalized patients due to the COVID-19 pandemic. Prone positioning has been shown to improve oxygenation, improve alveolar recruitment and decrease risks of mortality and ventilator-induced lung injury in the setting of acute respiratory distress syndrome. However, this strategy has not been examined in non-ventilated, spontaneously breathing patients requiring supplemental oxygen therapy.

This single-center, prospective cohort study examined the feasibility and efficacy of three hours of prone positioning in 56 non-intubated adult patients with COVID-19-related pneumonia requiring supplemental oxygen or continuous positive airway pressure in Monza, Italy. Prone positioning was associated with improvements in oxygenation from baseline to 10 minutes post-proning, but the improvements were not maintained after return to supine positioning in 50% of patients. The subset of patients with sustained response tended to be proned earlier and had significantly lower platelets and higher inflammatory markers than non-responders; however, intubation rates were comparable between responders and non-responders. Important limitations included lack of a control group and potential selection bias with non-consecutive enrolment, enrolment of patients requiring both CPAP and conventional oxygen therapy, and a single-centre design.

Click to read the study in The Lancet Respiratory Medicine

RELATED REPORTS

The 2 Minute Medicine Podcast Episode 27

Symptom and viral relapse more common in COVID-19 patients without antiviral treatment

The 2 Minute Medicine Podcast Episode 6

Click to read an accompanying editorial in The Lancet Respiratory Medicine

Relevant Reading: Prone positioning improves oxygenation in spontaneously breathing nonintubated patients with hypoxemic acute respiratory failure: A retrospective study

In-Depth [prospective cohort]: This single-center, prospective cohort study aimed to test the feasibility and efficacy of prone positioning in non-intubated patients with COVID-19-related pneumonia in Monza, Italy. Fifty-six patients aged 18-75 with confirmed COVID-19-related pneumonia requiring supplemental oxygen or continuous positive airway pressure (CPAP) were included; of note, patients with impending requirement of invasive ventilation were excluded. Oyxgenation was assessed at baseline (timepoint SP1) and 10 minutes after assisted prone positioning (timepoint PP1), and patients were supinated after 3 hours of pronation; measurements were repeated 1 hour after supination (timepoint SP2). Amongst 47 (83.9%) patients who tolerated prone positioning, data was available from 46. Findings showed that blood oxygenation improved by over 50% from baseline to 10 minutes after prone positioning (SP1 vs. PP1 PaO2/FiO2 ratio difference 104.9mmHg; 95% CI 10.9 to 134.0). However, this improvement was not maintained on average after supine positioning was resumed (SP1 vs. SP2 PaO2/FiO2 ratio difference 12.3mmHg; 95% CI -10.9 to 35.5; p=0.29). Improvements in blood oxygenation were maintained in 23 (50%) patients; these individuals were proned earlier and had significantly lower platelets and higher inflammatory markers than non-responders. Intubation rates were comparable between responders and non-responders (30% vs. 26%; p=0.74). Important limitations include lack of a control group and potential selection bias with non-consecutive enrolment, enrolment of patients requiring both CPAP and conventional oxygen therapy, and a single-centre design. Overall, this study suggests that prone positioning of non-intubated patients with COVID-19-related acute respiratory failure is feasible, and might provide significant, if transient, benefit to oxygenation levels.

Image: PD

©2020 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: Coronavirus
Previous Post

#VisualAbstract: Hospitalization and Mortality among Black Patients and White Patients with Covid-19

Next Post

Extreme risk protection orders protect individuals from firearm threats

RelatedReports

The 2 Minute Medicine Podcast Episode 15
2MM Podcast

The 2 Minute Medicine Podcast Episode 27

November 2, 2023
Decreased expression of nasal ACE2 may be correlated with lower prevalence of COVID-19 in children
Chronic Disease

Symptom and viral relapse more common in COVID-19 patients without antiviral treatment

March 21, 2023
2MM Podcast

The 2 Minute Medicine Podcast Episode 6

February 9, 2023
The Scan by 2 Minute Medicine®:  Ultra-Trail du Mont-Blanc, Taylor Swift, NBA rookie Chet Holmgren and Magic Mushrooms!
The Scan by 2 Minute Medicine®

The Scan by 2 Minute Medicine®: the Future of Medicine, Neuralink, the Spotlight on Celine Dion and COVID-19 on Social Media

December 27, 2022
Next Post
Quick Take: State Gun Laws, Gun Ownership, and Mass Shootings in the US: Cross-Sectional Time Series

Extreme risk protection orders protect individuals from firearm threats

Implementation of recreational cannabis laws correlated with an increase in traffic fatalities in Colorado, no significant change in Washington State

Intraoperative dexamethasone not effective at reducing major complications or mortality in infants undergoing cardiac surgery

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Seventh cervical nerve neurotomy may augment speech therapy in patients with chronic aphasia post-stroke
  • Time-restricted eating does not confer changes in sleep, mood, or quality of life
  • Commonly cited medication triggers may not increase risk of microscopic colitis among older adults
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.