Prone positioning in patients treated with non-invasive ventilation for COVID-19 pneumonia in an Italian emergency department

Emerg Med J. 2020 Sep;37(9):565-566. doi: 10.1136/emermed-2020-209744. Epub 2020 Jul 6.

Abstract

We report the experience of prone ventilation in selected patients treated with helmet non-invasive ventilation (NIV) continuous positive airway pressure (CPAP) for acute respiratory failure in COVID-19 pneumonia. Preliminary results showed an improvement in the PaO2 value and PaO2/FiO2 ratio after 1 hour of prone ventilation. No variation of the lung ultrasound pattern before and after prone ventilation has been detected. At the time of writing, we attempted proning with helmet NIV CPAP in 10 patients. In 4 out of 10 patients, the attempt failed due to lack of compliance of the patient, scarce pain control even with ongoing treatment and refusal by the patient to prone positioning.

Keywords: SARS; acute care; infectious diseases; non invasive; pneumonia/infections; respiratory; ventilation; viral.

MeSH terms

  • Aged
  • Betacoronavirus / isolation & purification
  • COVID-19
  • Continuous Positive Airway Pressure / methods*
  • Coronavirus Infections* / complications
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / physiopathology
  • Coronavirus Infections* / therapy
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Humans
  • Italy / epidemiology
  • Male
  • Noninvasive Ventilation / methods*
  • Oxygen Consumption
  • Oxygen Inhalation Therapy / methods
  • Pandemics*
  • Patient Positioning
  • Pneumonia, Viral* / complications
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / etiology
  • Pneumonia, Viral* / physiopathology
  • Pneumonia, Viral* / therapy
  • Prone Position*
  • Respiratory Insufficiency* / etiology
  • Respiratory Insufficiency* / physiopathology
  • Respiratory Insufficiency* / therapy
  • SARS-CoV-2
  • Treatment Outcome