Evaluation on Improvement of Respiratory Index in Patients with Respiratory Failure in ICU Nursing with Prone Position Ventilation

Rationale: The feasibility and safety of awake prone positioning and its impact on outcomes in non-intubated patients with acute respiratory distress syndrome secondary to COVID-19 is unknown. Results of the observational studies published during this pandemic have been conflicting. In this context, we conducted a multi-center, parallel group, randomized controlled feasibility study on awake prone positioning in non-intubated patients with COVID-19 pneumonia requiring supplemental oxygen. Methods: 60 patients with acute hypoxic respiratory failure secondary to COVID-19 pneumonia requiring 4 or more liters of oxygen to maintain a saturation of ≥92% were recruited in this study. Thirty patients each were randomized to either standard care or awake prone group. Patients randomized to the prone group were encouraged to self-prone for at least 6 hours a day. The primary outcome was the proportion of patients adhering to the protocol in each group. Results: In the prone group, 43% (13 out of 30) of patients were able to self-prone for 6 or more hours a day. In the supine group, 47% (14 out of 30) were completely supine and 53% spent some hours in the prone position, but none exceeded 6 hours. There was no significant difference in any of the secondary outcomes between the 2 groups and there were no adverse events. Conclusions: Awake prone positioning in non-intubated patients with acute hypoxic respiratory failure is feasible and safe under clinical trial conditions. The results of our feasibility study will potentially help in the design of larger definitive trials to address this key knowledge gap.

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Using the prone position for ventilated patients with respiratory failure: a review

Nursing in Critical Care ◽

10.1111/j.1478-5153.2010.00425.x ◽

2011 ◽

Vol 16 (1) ◽

pp. 19-27 ◽

Cited By ~ 10

Author(s):

Angie D Wright ◽

Maria Flynn

Keyword(s):

Respiratory Failure ◽

Prone Position ◽

Ventilated Patients

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Prone position ventilation in the Role 2 Afloat environment

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-103-26 ◽

2017 ◽

Vol 103 (1) ◽

pp. 26-29

Author(s):

A Hill ◽

C Hillman ◽

T E Scott

Keyword(s):

Respiratory Failure ◽

Knowledge Base ◽

Prone Position ◽

Material Resources ◽

Life Saving ◽

Hypoxic Respiratory Failure ◽

Ventilated Patients

AbstractProne position ventilation is a life-saving technique for the management of hypoxic respiratory failure in ventilated patients. It has particular application in the isolated Role 2 Afloat (R2A) environment where both human and material resources are limited. It can be achieved with minimal training. This article describes the rationale behind prone position ventilation and equips the reader with the knowledge base that will allow the technique to be instigated.

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Severe pneumonia with anemic syndrome.

Clinical Medicine (Russian Journal) ◽

10.18821/0023-2149-2018-96-3-267-272 ◽

2018 ◽

Vol 96 (3) ◽

pp. 267-272

Author(s):

Dmitry A. Arkhangelsky ◽

V. P. Butikov ◽

Yu. N. Zakrevsky ◽

Yu. E. Barachevsky ◽

A. G. Shevchenko ◽

...

Keyword(s):

Respiratory Failure ◽

Acute Respiratory Failure ◽

Clinical Case ◽

Severe Pneumonia ◽

Medical Evacuation ◽

Respiratory Index

The question of determining the criteria for medical evacuation of patients with severe pneumonia from remote regions is still poorly understood. Presented a clinical case of successful evacuation of a patient with severe pneumonia with the presence of anemia. The aim of the study was to evaluate anemia as a prediction of the possible development of acute respiratory failure in patients with pneumonia. Statistically significant associations of increased respiratory index (РаО2/FiO2) with hemoglobin levels (r=0,689 p=0.001) and the number of blood erythrocytes (r=0,683 p=0,001).

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Mechanical Ventilation in Neurocritical Patients

10.5772/intechopen.101029 ◽

2021 ◽

Author(s):

Thierry Hernández-Gilsoul ◽

Jose de Jesús Vidal-Mayo ◽

Alan Alexis Chacon-Corral

Keyword(s):

Mechanical Ventilation ◽

Respiratory Failure ◽

Intracranial Pressure ◽

Prone Position ◽

Neurocritical Care ◽

Lung Ventilation ◽

Permissive Hypercapnia ◽

Airway Protection ◽

Protective Lung Ventilation

Patients under neurocritical care may require mechanical ventilation for airway protection; respiratory failure can occur simultaneously or be acquired during the ICU stay. In this chapter, we will address the ventilatory strategies, in particular the role of protective lung ventilation, and the potential increase in intracranial pressure as a result of permissive hypercapnia, high airway pressures during recruitment maneuvers, and/or prone position. We will also describe some strategies to achieve mechanical ventilation liberation, including evaluation for tracheostomy, timing of tracheostomy, mechanical ventilation modalities for weaning and extubation, or tracheostomy weaning for mechanical ventilation.

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