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Prone positioning in mechanically ventilated patients with severe acute respiratory distress syndrome and coronavirus disease 2019

Acta Anaesthesiologica Scandinavica Dec 16, 2020

Gleissman H, Forsgren A, Andersson E, et al. - Researchers here examined whether prone positioning increases oxygenation in a case series of mechanically ventilated patients with COVID‐19 from a single, tertiary university hospital and evaluated responders. Change in PaO2:FiO2 was assessed as the primary measure. Treatment with proning was done in 44 patients, 32 males/12 females, for a total of 138 sessions, with median (range) two (1‐8) sessions. Median (IQR) time was 14 (12‐17) hours for the five sessions. Improvement in PaO2:FiO2 was noted in 36/44 patients (82%); a significant increase in PaO2:FiO2 was evident in the first three sessions. Findings overall suggested an increase in PaO2:FiO2 in correlation with proning, primarily in patients with PaO2:FiO2 approximately < 120 mm Hg, with a consistency over three sessions. They identified no characteristic to be linked with non‐responding, why proning may be considered in most patients.

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