@article {Jacquet-Lagr{\`e}ze713, author = {Matthias Jacquet-Lagr{\`e}ze and Zakaria Riad and Philippe Portran and Delphine Chesnel and R{\'e}mi Schweizer and Arnaud Ferarris and Louis Jacquemet and Martin Ruste and Jean-Luc Fellahi}, title = {Hemodynamic Effects of Awake Prone Positioning With COVID-19 Acute Respiratory Failure}, volume = {68}, number = {6}, pages = {713--720}, year = {2023}, doi = {10.4187/respcare.10597}, publisher = {Respiratory Care}, 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 {\textpm} 0.8 L/min/m2 in PP, 2.5 {\textpm} 0.6 L/min/m2 before PP (SP1), and 2.6 {\textpm} 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 {\textpm} 10\% in SP1, 46 {\textpm} 10\% during PP, and 35 {\textpm} 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.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/68/6/713}, eprint = {https://rc.rcjournal.com/content/68/6/713.full.pdf}, journal = {Respiratory Care} }