In:
Hong Kong Journal of Emergency Medicine, Wiley, Vol. 28, No. 6 ( 2021-11), p. 379-382
Abstract:
Significant ventilator‐associated pneumonia and mortality were found in COVID‐19 patients who required mechanical ventilation which calls for non‐invasive means in managing respiratory failure. Methods: We retrospectively reviewed patients admitted to the intensive care unit of Pamela Youde Nethersole Eastern Hospital in Hong Kong with severe acute respiratory syndrome coronavirus 2 infection from 28 November to 15 December 2020. Patients’ laboratory, respiratory parameters and outcome data were recorded and analysed. Results: Eleven received prone ventilation. The median age was 67 (inter‐quartile range: 59–72) years, and median COVID‐19 GRAM score was 151 (inter‐quartile range: 133–181), representing a high‐risk group. There were significant improvements 1 h after awake proning in SpO 2 (95% vs 92%, p = 0.008), FiO 2 (0.4 vs 0.5, p = 0.003), SpO 2 /FiO 2 (240 vs 184, p = 0.005), respiratory rate (19 vs 26, p = 0.006) and respiratory rate – oxygenation index (13.22 vs 7.67, p = 0.003; Table 1). Although not reaching statistical significance, the median PaO 2 , PaCO 2 and PaO 2 /FiO 2 improved after proning. The overall intubation rate was 22% and intensive care unit mortality was 22%, which is in contrast to 65.5% and 27.6%, respectively, in the first three waves. Although did not reach statistical significance, those received prone ventilation tend to have a lower ICU mortality (9.1% vs 42.9%, p = 0.245) and hospital mortality (18.2% vs 42.9%, p = 0.326). Conclusion: Awake proning potentially minimizes complications from invasive ventilation and provides a low‐cost low‐risk treatment option in COVID‐19 patients with respiratory failure. This is particularly important when healthcare resources are strained at times of a pandemic.
Type of Medium:
Online Resource
ISSN:
1024-9079
,
2309-5407
DOI:
10.1177/10249079211022914
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2917387-5
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