A Descriptive Study on Effectiveness of Prone Position on Prognosis of COVID-19 Patients in Selected Hospital

Dr. Ebenezer, Joy Kezia R, Thulasi L

Abstract: Background: Limited data are available on the use of prone position in intubated, invasively ventilated patients with Coronavirus disease-19 (COVID-19). Aim of this study is to investigate the use and effect of prone position in this population during the first 2020 pandemic wave. Methods: Retrospective, multicentre, national cohort study conducted [Dec 2021, Jan 2022 & Feb 2022] in Multidisplinary Critical Care Units (MDCCU) on adult patients needing invasive mechanical ventilation for respiratory failure caused by COVID-19. Clinical data were collected from the patient file. Information regarding the use of prone position was collected daily. The respiratory effects of the first prone position were studied in a subset of 60 patients. Patients were classified as Oxygen Responders if the PaO2/FiO2 ratio increased ? 20 mmHg during prone position and as Carbon Dioxide Responders if the ventilator ratio was reduced during prone position. Results: Out of 60 patients majority of the patients were aged between 30-40 years (38.4%), Hindus 46.6%, married 56.6%, secondary education 36.6%. With regard to other variables, 30% were diabetic, 28.4% of them were private employees, 51.6% of them had 3 or more children, 40% of them were admitted through ER, 43.4% of them stayed 20-30 days. Association between selected demographic variables and effectiveness of the prone position to increase the oxygenation of the patient with SARS-cov-2 pneumonia as a lung recruitment index was significant. the number of days the patient was on ventilator, that, majority of the patients were on ventilator >30 days 31.7%, on AC/PC mode 51.7%, plateau pressure before prone 40%, driving pressure before prone 38.4%. Plateau pressure after 24hrs of prone and driving pressure after 24hrs of prone nursing was 38.3%. The mean overall score of effectiveness was 13.2/57.39 with SD 2.93 with range of 7-20. There was statistical significant association between selected background variables and duration of stay (p<0.05). However there was no statistically significant association between background variables and age, patient prognosis (p>0.05). There was statistically significant association between selected background variables and duration of stay (p<0.05). However there was statistically significant association between background variables and age, patient prognosis (p<0.05). Conclusions: During the COVID-19 pandemic, prone position has been widely adopted to treat mechanically ventilated patients with respiratory failure. The majority of patients improved their oxygenation during prone position, most likely due to a better ventilation perfusion matching.

Keywords: Prone position in COVID-19, Acute respiratory distress syndrome, Mechanical ventilation, Pathophysiology, Plateau pressure, driving pressure, Nursing management of COVID-19

How to Cite?: Dr. Ebenezer, Joy Kezia R, Thulasi L, "A Descriptive Study on Effectiveness of Prone Position on Prognosis of COVID-19 Patients in Selected Hospital", Volume 11 Issue 6, June 2022, International Journal of Science and Research (IJSR), Pages: 162-167, https://www.ijsr.net/getabstract.php?paperid=SR22531122634, DOI: https://dx.doi.org/10.21275/SR22531122634

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