Compliance to not only prone but also lateral and supine positioning improves outcome in hospitalised COVID-19 patients

Link to article at PubMed

Int J Clin Pract. 2021 Jul 29:e14673. doi: 10.1111/ijcp.14673. Online ahead of print.


BACKGROUND: Positioning of the patient is a common strategy to increase oxygenation in management of acute respiratory distress syndrome. Aim of this study is to demonstrate the effects of our positioning approach on disease outcomes in COVID-19 patients with respiratory failure, by comparing patients compliant to positioning and not.

METHODS: Covid-19 patients who were admitted to our internal medicine inpatient clinic and developed hypoxemia and underwent positioning during hospital stay were retrospectively investigated for compliance to positioning. Rates of mortality, intensive care unit admission, intubation, initiation of anti-inflammatory treatment and length of hospital stay were compared between patients with and without compliance to positioning.

RESULTS: A total of 144 patients were enrolled in this study (97 compliant with positioning, 47 incompliant with positioning). Rates of ICU admission (7.2% vs 25.5%, p<0.001), anti-inflammatory treatment initiation (68% vs 97.9%, p<0.001) and length of hospital stay (5(2-16) days vs 12(3-20) days, p<0.001) were significantly reduced in patients compliant with positioning.

CONCLUSION: Prone or other positioning should be considered in patients with noninvasive oxygen support for the potential to reduce rates of intensive care unit admissions, airway interventions, anti-inflammatory treatment initiation and mortality.

PMID:34324243 | DOI:10.1111/ijcp.14673

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