Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun 9;323(22):2336-2338.
doi: 10.1001/jama.2020.8255.

Use of Prone Positioning in Nonintubated Patients With COVID-19 and Hypoxemic Acute Respiratory Failure

Xavier Elharrar  1 , Youssef Trigui  1 , Anne-Marie Dols  2 , François Touchon  1 , Stéphanie Martinez  1 , Eloi Prud'homme  3 , Laurent Papazian  4
Affiliations

Use of Prone Positioning in Nonintubated Patients With COVID-19 and Hypoxemic Acute Respiratory Failure

Xavier Elharrar et al. JAMA. .

Abstract

This case series describes the proportion of awake, nonintubated inpatients with COVID-19 and hypoxemic respiratory failure requiring oxygen supplementation whose Pao2 increased ≥20% with prone positioning, and their respiratory status after resuming supine positioning.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Papazian reported receiving personal fees from Air Liquide and Merck Sharp & Dohme, grants from Sedana, and nonfinancial support from Medtronic, Lowenstein, and Hamilton outside the submitted work. No other disclosures were reported.

Figures

Figure.
Figure.. Individual Partial Pressure of Arterial Oxygen (Pao2) Variation for Patients Who Sustained Prone Positioning (PP) for at Least 3 Hours
During PP indicates the 1 to 2 hours after proning and after PP indicates the 6 to 12 hours after resupination. Responders to PP = Pao2 increase ≥20% between before and during PP. Persistent responders to PP = Pao2 increase ≥20% between before PP and after resupination. All the persistent responders are also responders. One patient among the 15 refused arterial blood gas measurement during PP and after resupination. For 2 patients, arterial blood gas data after resupination were missing.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Grasselli G, Zangrillo A, Zanella A, et al. ; COVID-19 Lombardy ICU Network . Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA. Published online April 6, 2020. doi:10.1001/jama.2020.5394 - DOI - PMC - PubMed
    1. Munshi L, Del Sorbo L, Adhikari NKJ, et al. . Prone position for acute respiratory distress syndrome. a systematic review and meta-analysis. Ann Am Thorac Soc. 2017;14(supplement_4):S280-S288. doi:10.1513/AnnalsATS.201704-343OT - DOI - PubMed
    1. Guérin C, Reignier J, Richard J-C, et al. ; PROSEVA Study Group . Prone positioning in severe acute respiratory distress syndrome. N Engl J Med. 2013;368(23):2159-2168. doi:10.1056/NEJMoa1214103 - DOI - PubMed
    1. Sun Q, Qiu H, Huang M, Yang Y. Lower mortality of COVID-19 by early recognition and intervention: experience from Jiangsu Province. Ann Intensive Care. 2020;10(1):33. doi:10.1186/s13613-020-00650-2 - DOI - PMC - PubMed
    1. Scaravilli V, Grasselli G, Castagna L, et al. . Prone positioning improves oxygenation in spontaneously breathing nonintubated patients with hypoxemic acute respiratory failure: a retrospective study. J Crit Care. 2015;30(6):1390-1394. doi:10.1016/j.jcrc.2015.07.008 - DOI - PubMed

MeSH terms