RT Journal Article
SR Electronic
T1 Hemodynamic Effects of Awake Prone Positioning With COVID-19 Acute Respiratory Failure
JF Respiratory Care
FD American Association for Respiratory Care
SP 713
OP 720
DO 10.4187/respcare.10597
VO 68
IS 6
A1 Matthias Jacquet-Lagrèze
A1 Zakaria Riad
A1 Philippe Portran
A1 Delphine Chesnel
A1 Rémi Schweizer
A1 Arnaud Ferarris
A1 Louis Jacquemet
A1 Martin Ruste
A1 Jean-Luc Fellahi
YR 2023
UL http://rc.rcjournal.com/content/68/6/713.abstract
AB 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.