|Title:||Prone-Positioning in Awake Non Intubated Patients with COVID19 Hypoxaemic Failure: A Single Centre Prospective Cohort Study|
|Author(s):||A Duncan D Halim K Kholy S Toland A Asis I Sulaiman|
|Poster:||Click to view poster|
|Abstract:||A surge in critically-ill patients with respiratory failure secondary to COVID-19 has overwhelmed ICU capacity in many healthcare systems across the world1. Given significant resource limitations, less-invasive and inventive approaches such as prone-positioning (PP) of non-intubated patients with hypoxaemic respiratory failure was implemented 2,3. |
This is a prospective observational study. The aim is to evaluate the impact of awake PP at ward level on oxygenation levels of patients with COVID-19 requiring supplemental oxygen.
The primary outcome is to evaluate the change in SpO2:FiO2 (SF) before and after PP. SF is compared in the participants who tolerated and those that did not tolerate PP. Secondary outcomes are assessment of risk-factors of treatment failure (requirement for ICU or death).
A total of 63 patients admitted to Beaumont Hospital between January and February of 2021 were recruited. 47 (74%) participants were reported as tolerating and 16 (26%) as non-tolerating. Table 1 shows baseline demographics. The mean change in SF in the tolerating group was 38 vs 16 non-tolerating. This was statistically significant (P <0.001) with a mean difference of 22. A regression model was utilised to show SF ratio on admission, BMI and age are all significant and strong predictors for length of stay and treatment failure (R2=0.52, P<0.05).
PP was associated with improvements in oxygenation parameters without any reported adverse events. A well-designed RCT testing the efficacy of PP in non-intubated COVID-19 patients is needed to give more robust evidence prior to widespread adoption of this practice.