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Abstract
INTRODUCTION: Awake prone positioning (PP) reduces need for intubation for patients with COVID-19 with acute respiratory failure. We investigated the hemodynamic effects of awake PP in non-ventilated subjects with COVID-19 acute respiratory failure.
METHODS: We conducted a single-center prospective cohort study. Adult hypoxemic subjects with COVID-19 not requiring invasive mechanical ventilation receiving at least one PP session were included. Hemodynamic assessment was done with transthoracic echocardiography before, during, and after a PP session.
RESULTS: Twenty-six subjects were included. We observed a significant and reversible increase in cardiac index (CI) during PP compared to supine position (SP): 3.0 ± 0.8 L/min/m2 in PP, 2.5 ± 0.6 L/min/m2 before PP (SP1), and 2.6 ± 0.5 L/min/m2 after PP (SP2, P < .001). A significant improvement in right ventricular (RV) systolic function was also evidenced during PP: The RV fractional area change was 36 ± 10% in SP1, 46 ± 10% during PP, and 35 ± 8% in SP2 (P < .001). There was no significant difference in PaO2/FIO2 and breathing frequency.
CONCLUSION: CI and RV systolic function are improved by awake PP in non-ventilated subjects with COVID-19 with acute respiratory failure.
Footnotes
- Correspondence: Matthias Jacquet-Lagrèze MD PhD, Service d’anesthésie-réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, 59, Boulevard Pinel, 69394 Lyon Cedex, France. E-mail: matthias.jacquet-lagreze{at}chu-lyon.fr
See the Related Editorial on Page 852
Dr Jacquet-Lagrèze is cofounder and shareholder of DiCARTECH, a company created to build and sell a device that measures the capillary refill time. Dr Jacquet-Lagrèze discloses relationships with Baxter, Edwards, and Dräger.
- Copyright © 2023 by Daedalus Enterprises
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