Belqis Elferjani, MD
Internal Medicine Resident
Southeast Health, United States
Disclosure information not submitted.
Awais Farooq, MD
Internal Medicine Resident
Southeast Health, United States
Disclosure information not submitted.
Pooja Patak, MD
Internal Medicine Resident
Southeast Health, United States
Disclosure information not submitted.
Devesh Dahale, MS, MBA
Health Systems Engineer
Southeast Health, United States
Disclosure information not submitted.
Dhaval Pau, MD
Critical Care Intensivist
Southeast Health, United States
Disclosure information not submitted.
Title: The Effect of Prone Positioning on Mortality in COVID-19 related ARDS: A Retrospective Analysis
Introduction: Previous studies have suggested a survival benefit of prone positioning in acute respiratory distress syndrome (ARDS) but its role in COVID-19 related ARDS remains unclear. In addition, the benefit of proning in patients needing non-invasive ventilation is also unclear.
Objective: To determine the effect of prone positioning on the outcomes of patients with ARDS related to COVID-19.
Methods: Patients with ARDS due to COVID-19 admitted to the ICU at our tertiary care community hospital between March 2020 and September 2020 were included in this study. Patients needing both invasive and non-invasive mechanical ventilation were included and separately analyzed. Patients were divided into two groups and compared: those who underwent proning and those who did not undergo proning.
Results: A total of 235 patients were identified, out of which 29 patients were excluded because it was not clear from the medical record whether or not they underwent proning. 128 patients required invasive mechanical ventilation, out of which 22% underwent prone ventilation and 78% did not. 78 patients were managed with non-invasive ventilation, out of which 27% underwent proning and 73% did not. Among patients needing invasive mechanical ventilation, patients who underwent proning had a 28-day mortality of 57% versus 66% for those who did not undergo proning, p< 0.001. Among patients needing non-invasive ventilation, patients who underwent proning had a 28-day mortality of 10% versus 21% for those who did not undergo proning, p< 0.001.
Conclusion: Proning appeared to have a statistically and clinically significant main effect of approximately 10% lower mortality for critically ill patients with COVID-19 ARDS needing both invasive and non-invasive mechanical ventilation.