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Efficacy of early prone or lateral positioning in patients with severe COVID-19:a single-center prospective cohort

Precision Clinical Medicine 2020年第4期3卷 260-271页

作者： Zhong Ni Kaige Wang Ting Wang Yuenan Ni Wei Huang Ping Zhu Tao Fan Ye Wang Bo Wang Jun Deng Zhicheng Qian Jiasheng Liu Wenhao Cai Shanling Xu Yu Du Gang Wang Zongan Liang Weimin Li Jianfei Luo Fengming Luo Dan Liu Department of Respiratory and Critical Care Medicine Clinical Research Center for Respiratory DiseaseWest China HospitalSichuan UniversityChengdu 610041China Department of Integrated Traditional Chinese and Western Medicine West China HospitalSichuan UniversityChengdu 610041China Department of Respiratory and Critical Care Medicine The Affiliated Hospital of Southwest Medical UniversityLuzhou 646000China Intensive Care Unit the Affiliated Hospital of North Sichuan Medical CollegeNanchong 637000China Department of Gastrointestinal Surgery Renmin Hospital of Wuhan UniversityWuhan 430060China Critical Care Medicine Department Sichuan Cancer HospitalAffiliated Cancer Hospital to University of Electronic Science and Technology of ChinaChengdu 610041China Department of Emergency and Critical Care Medicine West China School of Public HealthWest China Fourth HospitalSichuan UniversityChengdu 610041China

Background:position intervention has been shown to improve oxygenation,but its role in non-invasively ventilated patients with severe COVID-19 has not been *** objective of this study was to investigate the efficacy of early position intervention on non-invasively ventilated patients with severe ***:This was a single-center,prospective observational study in consecutive patients with severe COVID-19 managed in a provisional ICU at Renmin Hospital of Wuhan University from 31 January to 15 February *** with chest CT showing exudation or consolidation in bilateral peripheral and posterior parts of the lungs were *** position intervention(prone or lateral)was commenced for>4 hours daily for 10 days in these patients,while others received standard ***:The baseline parameters were comparable between the position intervention group(n=17)and the standard care group(n=35).position intervention was well-tolerated and increased cumulative adjusted mean difference of SpO_(2)/FiO_(2)(409,95%CI 86 to 733)and ROX index(26,95%CI 9 to 43)with decreased Borg scale(−9,95%CI−15 to−3)during the first 7 *** also facilitated absorption of lung lesions and reduced the proportion of patients with high National early Warning Score 2(≥7)on days 7 and 14,with a trend toward faster clinical *** shedding and length of hospital stay were comparable between the two ***:This study provides the first evidence for improved oxygenation and lung lesion absorption using early position intervention in non-invasively ventilated patients with severe COVID-19,and warrants further randomized trials.

关键词： COVID-19 early position intervention oxygenation ROX index Borg scale

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