Analysis of the impact of pronation maneuver in patients on mechanical ventilation with diagnosis of pneumonia by Covid-19 and acute respiratory distress syndrome
Análise do impacto da manobra de pronação em pacientes em ventilação mecânica com diagnóstico de pneumonia por Covid-19 e síndrome do desconforto respiratório agudo
DOI:
https://doi.org/10.34119/bjhrv5n6-175Keywords:
acute respiratory distress syndrome, pronation, COVID-19Abstract
Objective: To analyze the profile of patients on invasive mechanical ventilation with SARS-CoV-2 pneumonia who were pronated and who developed acute respiratory distress syndrome. Methods: Historical cohort study through the analysis of a database containing 282 patients hospitalized in a large university hospital in the city of Porto Alegre, Brazil. The population studied included individuals infected with SARS-CoV-2 and with a clinical course marked by severe pneumonia and, mainly, by acute respiratory distress syndrome, submitted to mechanical ventilation and invasive pronation maneuver. Results: Database analysis showed a high mortality rate for all patient groups and a high case fatality rate, especially in elderly patients and in individuals with active oncologic disease or with chronic kidney disease. Conclusions: The high overall mortality rate, as well as the high lethality, especially in elderly patients and in individuals with active oncologic disease or with chronic kidney disease, suggests that, for certain specific population groups, the prone maneuver is not effective in reducing high. mortality caused by acute respiratory distress syndrome associated with COVID-19.
References
Coronavirus disease (COVID-19) pandemic. Available from: https://www.who.int/europe/emergencies/situations/covid-19
Graham Carlos W, dela Cruz CS, Cao B, Pasnick S, Jamil S. Novel Wuhan (2019-nCoV) Coronavirus. Am J Respir Crit Care Med. 2020;201(4):P7–8.
Wilder-Smith A, Teleman MD, Heng BH, Earnest A, Ling AE, Leo YS. Asymptomatic SARS coronavirus infection among healthcare workers, Singapore. Emerg Infect Dis. 200;11(7):1142–5.
Ochani RK, Kumar Ochani R, Asad A, Yasmin F, Shaikh S, Khalid H, et al. COVID-19 pandemic: from origins to outcomes. A comprehensive review of viral pathogenesis, clinical manifestations, diagnostic evaluation, and management. Le Infezioni in Medicina. 2021;20:20–36.
Ji T, Liu Z, Wang GQ, Guo X, Akbar khan S, Lai C, et al. Detection of COVID-19: A review of the current literature and future perspectives. Biosens Bioelectron. 2020;166:112455.
Pontone G, Scafuri S, Mancini ME, Agalbato C, Guglielmo M, Baggiano A, et al. Invited review Role of computed tomography in COVID-19. 2021.
COVID-19 Treatment Guidelines. Available from: https://www.covid19treatmentguidelines.nih.gov/
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395:497–506.
Meyer NJ, Gattinoni L, Calfee CS. Seminar Acute respiratory distress syndrome. www.thelancet.com. 2021;398:2021.
Guérin C, Albert RK, Beitler J, Gattinoni L, Jaber S, Marini JJ, et al. Prone position in ARDS patients: why, when, how and for whom. Intensive Care Med. 2020;46:2385–96.
Voggenreiter G, Aufmkolk M, Stiletto RJ, Baacke MG, Waydhas C, Ose C, et al. Prone positioning improves oxygenation in post-traumatic lung injury--a prospective randomized trial. J Trauma. 2005;59(2):333–43. Available from:
Beuret P, Carton MJ, Nourdine K, Kaaki M, Tramoni G, Ducreux JC. Prone position as prevention of lung injury in comatose patients: a prospective, randomized, controlled study. Intensive Care Medicine 2002;28(5):564–9.
Curley MAQ, Hibberd PL, Fineman LD, Wypij D, Shih MC, Thompson JE, et al. Effect of prone positioning on clinical outcomes in children with acute lung injury: a randomized controlled trial. JAMA. 2005;294(2):229–37.
A Cunha MC, Schardonga J, Camponogara Righi N, Claudia Lunardi A, Nery de Sant G, Padrão Isensee L, et al. Impacto da pronação em pacientes com COVID-19 e SDRA em ventilação mecânica invasiva: estudo de coorte multicêntrico. 2022.
Chen Y, Zhang J, Feng H, Wan F, Zhang Y, Tan L. Prone positioning in intubated and mechanically ventilated patients with SARS-CoV-2. J Clin Anesth. 2021;71.
Gibson PG, Qin L, Puah SH. COVID-19 acute respiratory distress syndrome (ARDS): clinical features and differences from typical pre-COVID-19 ARDS. Med J Aust. 2020;213(2):54-56.e1.
Weiss TT, Cerda F, Scott JB, Kaur R, Sungurlu S, Mirza SH, et al. Prone positioning for patients intubated for severe acute respiratory distress syndrome (ARDS) secondary to COVID-19: a retrospective observational cohort study. BJA: British Journal of Anaesthesia. 2021;126(1):48.
Parhar KKS, Zuege DJ, Shariff K, Knight G, Bagshaw SM. Prone positioning for ARDS patients-tips for preparation and use during the COVID-19 pandemic. Can J Anaesth. 202;68(4):541–5.
Guérin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T, et al. Prone Positioning in Severe Acute Respiratory Distress Syndrome. New England Journal of Medicine. 2013;368(23):2159–68.
Shelhamer MC, Wesson PD, Solari IL, Jensen DL, Steele WA, Dimitrov VG, et al. Prone Positioning in Moderate to Severe Acute Respiratory Distress Syndrome Due to COVID-19: A Cohort Study and Analysis of Physiology. J Intensive Care Med. 2021;36(2):241–52.
Estenssoro E, Loudet CI, Ríos FG, Kanoore Edul VS, Plotnikow G, Andrian M, et al. Clinical characteristics and outcomes of invasively ventilated patients with COVID-19 in Argentina (SATICOVID): a prospective, multicentre cohort study. Lancet Respir Med. 2021;9(9):989–98.
Langer T, Brioni M, Guzzardella A, Carlesso E, Cabrini L, Castelli G, et al. Prone position in intubated, mechanically ventilated patients with COVID-19: a multi-centric study of more than 1000 patients. Crit Care. 2021;25(1).
Ruch Y, Kaeuffer C, Ohana M, Labani A, Fabacher T, Bilbault P, et al. CT lung lesions as predictors of early death or ICU admission in COVID-19 patients. Clin Microbiol Infect. 2020;26(10):1417.e5-1417.e8.
