Large reviews have shown that placing hospitalized COVID-19 patients using oxygen face down significantly improves their chances of survival.
Research on non-intubated patients, published in peer-reviewed journals Respiratory care, As a way to improve, it provides an important validation of the practices that are widespread in COVID units. Oxygen intake And clinical outcome.
“Prone position is a non-invasive way to improve a patient. air “We will increase the level while reducing the need for high oxygen therapy,” said Dr. Azura Belan, a trainee in internal medicine at the University of Toledo School of Medicine and Life Sciences and the lead author of the paper. However, its effects on non-intubated patients have not been deeply evaluated. “
Patients can tolerate 100% oxygen for a short period of time, but long-term use of pure oxygen can damage the lungs. Prone position, or abdominal down, helps keep the lungs open and helps reduce the oxygen levels needed to maintain physical function.
A team of Beran and UToledo researchers analyzed 14 separate studies comparing the clinical outcomes of unintubated COVID-19 patients. Prone position For those who were lying on their backs while receiving oxygen therapy.
They found that patients in the prone position had a mortality rate of 17.9%, while those who did not had a mortality rate of 25.7%.
“We know that prone positioning improves oxygenation,” Belan said. “This analysis is by far the largest of its kind and shows that it also reduces the number of deaths in hospitalized COVID-19 patients.”
Studies have also found that prone positioning during oxygen therapy can potentially reduce the need for much more invasive mechanical ventilation.
A combined analysis of all 14 studies showed no statistically significant difference in the number of patients who were finally intubated. However, looking at only five randomized controlled trials, researchers found a significant reduction in intubation in patients placed in the prone position while receiving oxygen therapy.
In these five studies, researchers found that 30.2% of patients who adopted the prone position eventually required intubation, compared to 36.9% of those who did not adopt the prone position. did.
Dr. Ragheb Assaly, a professor of medicine, director of internal medicine training programs, and lead author of the dissertation, said this type of research is very important as COVID-19 continues to spread and causes serious illness and death. I said there is.
Assaly, head of the Department of Pulmonary Emergency and Sleep Medicine, said many medical centers are exploring the idea of creating a “prone position team” that can help nursing staff move patients in and out. I mentioned that this paper is particularly timely. Prone position.
“Some scientists are discussing the potential of COVID-19 to become endemic, so we need a better answer to standardize the care of COVID patients,” he said. “Our hope is that this study will inspire larger randomized controlled trials and answer questions with much more confidence.”
Beran, a third-year intern at UToledo, also considers this task to be the basis, while the evidence provided in the paper guides the benefits used by physicians treating COVID-19. The prone position of an unintubated patient said it may help.
“I’m fortunate to have a support teacher here,” Belan said. “I have been working on many research projects with many faculty members here at U Toledo. We are always encouraged and supported to continue our academic activities. It is because we grow as residents and better doctors. I think it helps to become. ”
Azizullah Beran et al, Effect of Prone Positioning on Clinical Outcomes of Non-Intubated Subjects of COVID-19: Comparative Systematic Review and Meta-Analysis, Respiratory care (2021). DOI: 10.4187 /respcare.09362
University of Toledo
Quote: Tendency positioning improves survival in hospitalized COVID patients, studies from https://medicalxpress.com/news/2021-12-prone-positioning-survival-hospitalized-covid.html 2021 12 Confirm that it was acquired on the 15th of March (December 15, 2021)
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Studies confirm that prone position improves survival in hospitalized COVID patients
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