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
. 2021 Mar 8;7(1):00692-2020.
doi: 10.1183/23120541.00692-2020. eCollection 2021 Jan.

Self-proning in COVID-19 patients on low-flow oxygen therapy: a cluster randomised controlled trial

Aileen Kharat  1   2 , Elise Dupuis-Lozeron  3   4 , Chloé Cantero  1 , Christophe Marti  3   5 , Olivier Grosgurin  5 , Sanaz Lolachi  5 , Frédéric Lador  1   3 , Jérôme Plojoux  1   3 , Jean-Paul Janssens  1   3 , Paola M Soccal  1   3 , Dan Adler  1   3
Affiliations

Self-proning in COVID-19 patients on low-flow oxygen therapy: a cluster randomised controlled trial

Aileen Kharat et al. ERJ Open Res. .

Abstract

Rationale and objectives: Prone positioning as a complement to oxygen therapy to treat hypoxaemia in coronavirus disease 2019 (COVID-19) pneumonia in spontaneously breathing patients has been widely adopted, despite a lack of evidence for its benefit. We tested the hypothesis that a simple incentive to self-prone for a maximum of 12 h per day would decrease oxygen needs in patients admitted to the ward for COVID-19 pneumonia on low-flow oxygen therapy.

Methods: 27 patients with confirmed COVID-19 pneumonia admitted to Geneva University Hospitals were included in the study. 10 patients were randomised to self-prone positioning and 17 to usual care.

Measurements and main results: Oxygen needs assessed by oxygen flow on nasal cannula at inclusion were similar between groups. 24 h after starting the intervention, the median (interquartile range (IQR)) oxygen flow was 1.0 (0.1-2.9) L·min-1 in the prone position group and 2.0 (0.5-3.0) L·min-1 in the control group (p=0.507). Median (IQR) oxygen saturation/fraction of inspired oxygen ratio was 390 (300-432) in the prone position group and 336 (294-422) in the control group (p=0.633). One patient from the intervention group who did not self-prone was transferred to the high-dependency unit. Self-prone positioning was easy to implement. The intervention was well tolerated and only mild side-effects were reported.

Conclusions: Self-prone positioning in patients with COVID-19 pneumonia requiring low-flow oxygen therapy resulted in a clinically meaningful reduction of oxygen flow, but without reaching statistical significance.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: A. Kharat has nothing to disclose. Conflict of interest: E. Dupuis-Lozeron has nothing to disclose. Conflict of interest: C. Cantero has nothing to disclose. Conflict of interest: C. Marti has nothing to disclose. Conflict of interest: O. Grosgurin has nothing to disclose. Conflict of interest: S. Lolachi has nothing to disclose. Conflict of interest: F. Lador has nothing to disclose. Conflict of interest: J. Plojoux has nothing to disclose. Conflict of interest: J-P. Janssens has nothing to disclose. Conflict of interest: P.M. Soccal has nothing to disclose. Conflict of interest: D. Adler has nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Study flowchart. ICU: intensive care unit; COVID-19: coronavirus disease 2019.
FIGURE 2
FIGURE 2
a) Oxygen (O2) flow on nasal cannula in the self-proning group and in the control group; b) peripheral oxygen saturation (SpO2)/inspiratory oxygen fraction (FiO2) ratio in the self-proning group and in the control group. Data are presented as median, interquartile range and 90th and 10th percentile.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323: 1239–1242. doi:10.1001/jama.2020.2648 - DOI - PubMed
    1. Yang X, Yu Y, Xu J, et al. . Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8: 475–481. doi:10.1016/S2213-2600(20)30079-5 - DOI - PMC - PubMed
    1. Grasselli G, Pesenti A, Cecconi M. Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response. JAMA 2020; 323: 1545–1546. doi:10.1001/jama.2020.4031 - DOI - PubMed
    1. Sanders JM, Monogue ML, Jodlowski TZ, et al. . Pharmacologic treatments for coronavirus disease 2019 (COVID-19): a review. JAMA 2020; 323: 1824–1836. doi:10.1001/jama.2019.20153 - DOI - PubMed
    1. Fan E, Del Sorbo L, Goligher EC, et al. . An official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine clinical practice guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 2017; 195: 1253–1263. doi:10.1164/rccm.201703-0548ST - DOI - PubMed

LinkOut - more resources