Prone positioning in COVID-19 patients with acute respiratory distress syndrome and invasive mechanical ventilation
Copyright © 2022 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Published by Elsevier España, S.L.U. All rights reserved..
OBJECTIVE: To identify adverse events related to prone positioning in COVID-19 patients with severe disease and acute respiratory distress syndrome, to analyze the risk factors associated with the development of anterior pressure ulcers, to determine whether the recommendation of prone positioning is associated with improved clinical outcomes.
METHODS: Retrospective study performed in 63 consecutive patients with COVID-19 pneumonia admitted to intensive care unit on invasive mechanical ventilation and treated with prone positioning between March and April 2020. Association between prone-related pressure ulcers and selected variables was explored by the means of logistic regression.
RESULTS: A total of 139 proning cycles were performed. The mean number of cycles were 2 [1-3] and the mean duration per cycle was of 22h [15-24]. The prevalence of adverse events this population was 84.9 %, being the physiologic ones (i.e., hypo/hypertension) the most prevalent. 29 out of 63 patients (46%) developed prone-related pressure ulcers. The risk factors for prone-related pressure ulcers were older age, hypertension, levels of pre-albumin <21mg/dl, the number of proning cycles and severe disease. We observed a significant increase in the PaO2/FiO2 at different time points during the prone positioning, and a significant decrease after it.
CONCLUSIONS: There is a high incidence of adverse events due to PD, with the physiological type being the most frequent. The identification of the main risk factors for the development of prone-related pressure ulcers will help to prevent the occurrence of these lesions during the prone positioning. Prone positioning offered an improvement in the oxygenation in these patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
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| Enthalten in: |
Enfermeria intensiva - 34(2023), 2 vom: 15. Apr., Seite 70-79 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Barja-Martínez, E [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 12.06.2023 Date Revised 19.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.enfie.2022.09.002 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM354394681 |
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| 500 | |a Date Revised 19.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Published by Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a OBJECTIVE: To identify adverse events related to prone positioning in COVID-19 patients with severe disease and acute respiratory distress syndrome, to analyze the risk factors associated with the development of anterior pressure ulcers, to determine whether the recommendation of prone positioning is associated with improved clinical outcomes | ||
| 520 | |a METHODS: Retrospective study performed in 63 consecutive patients with COVID-19 pneumonia admitted to intensive care unit on invasive mechanical ventilation and treated with prone positioning between March and April 2020. Association between prone-related pressure ulcers and selected variables was explored by the means of logistic regression | ||
| 520 | |a RESULTS: A total of 139 proning cycles were performed. The mean number of cycles were 2 [1-3] and the mean duration per cycle was of 22h [15-24]. The prevalence of adverse events this population was 84.9 %, being the physiologic ones (i.e., hypo/hypertension) the most prevalent. 29 out of 63 patients (46%) developed prone-related pressure ulcers. The risk factors for prone-related pressure ulcers were older age, hypertension, levels of pre-albumin <21mg/dl, the number of proning cycles and severe disease. We observed a significant increase in the PaO2/FiO2 at different time points during the prone positioning, and a significant decrease after it | ||
| 520 | |a CONCLUSIONS: There is a high incidence of adverse events due to PD, with the physiological type being the most frequent. The identification of the main risk factors for the development of prone-related pressure ulcers will help to prevent the occurrence of these lesions during the prone positioning. Prone positioning offered an improvement in the oxygenation in these patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute respiratory distress syndrome | |
| 650 | 4 | |a Adverse event | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Critical care | |
| 650 | 4 | |a Cuidados intensivos | |
| 650 | 4 | |a Decúbito prono | |
| 650 | 4 | |a Evento adverso | |
| 650 | 4 | |a Pressure ulcer | |
| 650 | 4 | |a Prone position | |
| 650 | 4 | |a Síndrome de distrés respiratorio agudo | |
| 650 | 4 | |a Úlcera por presión | |
| 700 | 1 | |a García-González, S |e verfasserin |4 aut | |
| 700 | 1 | |a Jiménez-García, E |e verfasserin |4 aut | |
| 700 | 1 | |a Thuissard-Vasallo, I J |e verfasserin |4 aut | |
| 700 | 1 | |a Arias-Rivera, S |e verfasserin |4 aut | |
| 700 | 1 | |a Blanco-Abril, S |e verfasserin |4 aut | |
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