PDF(Pubmed)
Abstract：
UNASSIGNED: Previous studies suggest that prone positioning can increase PaO2/FiO2 and reduce mortality in moderate to severe acute respiratory distress syndrome. Effect of prone positioning and high flow nasal oxygen has been studied individually in COVID-19 patients but their combined effect on patient\'s outcome is yet to be reported.
UNASSIGNED: In this study 120 severe COVID-19 positive patients were included and placed in awake prone positioning with high flow nasal oxygen. The efficacy in improving oxygenation with prone positioning and high flow nasal oxygen were evaluated by blood gas analysis. The primary outcome was a proportion of patients requiring non-invasive ventilation or invasive ventilation. The secondary outcomes were a comparison of arterial blood gas parameters and biochemical inflammatory parameters pre proning, end of first proning and end of last prone position in these patients.
UNASSIGNED: We found only 35 patients (34.3%) required the need for non-invasive or invasive mechanical ventilation support whereas 67 patients (65.7%) were managed successfully on high flow nasal oxygen along with awake prone positioning (p = 0.001). We found there were statistically significant improvements in arterial blood gas parameters and biochemical inflammatory markers after the end of last prone positioning with high flow nasal oxygen.
UNASSIGNED: Early application of prone positioning in combination with high flow nasal oxygen may help in avoiding mechanical ventilation by improving oxygenation and biochemical inflammatory markers.
UNASSIGNED: In this study 120 severe COVID-19 positive patients were included and placed in awake prone positioning with high flow nasal oxygen. The efficacy in improving oxygenation with prone positioning and high flow nasal oxygen were evaluated by blood gas analysis. The primary outcome was a proportion of patients requiring non-invasive ventilation or invasive ventilation. The secondary outcomes were a comparison of arterial blood gas parameters and biochemical inflammatory parameters pre proning, end of first proning and end of last prone position in these patients.
UNASSIGNED: We found only 35 patients (34.3%) required the need for non-invasive or invasive mechanical ventilation support whereas 67 patients (65.7%) were managed successfully on high flow nasal oxygen along with awake prone positioning (p = 0.001). We found there were statistically significant improvements in arterial blood gas parameters and biochemical inflammatory markers after the end of last prone positioning with high flow nasal oxygen.
UNASSIGNED: Early application of prone positioning in combination with high flow nasal oxygen may help in avoiding mechanical ventilation by improving oxygenation and biochemical inflammatory markers.
摘要：
■先前的研究表明，俯卧位可以增加中度至重度急性呼吸窘迫综合征的PaO2/FiO2并降低死亡率。俯卧位和高流量鼻氧的影响已经在COVID-19患者中进行了单独研究，但它们对患者预后的综合影响尚未报道。
■在这项研究中，纳入了120名严重COVID-19阳性患者，并将其置于清醒的倾向位置，并使用高流量鼻氧。通过血气分析评估了俯卧位和高流量鼻氧改善氧合的功效。主要结果是需要无创通气或有创通气的患者比例。次要结果是比较动脉血气参数和生化炎症参数，这些患者的第一次俯卧位结束和最后俯卧位结束。
■我们发现只有35例患者（34.3%）需要非侵入性或侵入性机械通气支持，而67例患者（65.7%）在高流量鼻氧和易醒定位下成功治疗（p=0.001）。我们发现，在使用高流量鼻氧的最后一次俯卧位结束后，动脉血气参数和生化炎症标志物有统计学上的显着改善。
■俯卧位与高流量鼻氧结合的早期应用可能有助于通过改善氧合和生化炎症标志物来避免机械通气。
■在这项研究中，纳入了120名严重COVID-19阳性患者，并将其置于清醒的倾向位置，并使用高流量鼻氧。通过血气分析评估了俯卧位和高流量鼻氧改善氧合的功效。主要结果是需要无创通气或有创通气的患者比例。次要结果是比较动脉血气参数和生化炎症参数，这些患者的第一次俯卧位结束和最后俯卧位结束。
■我们发现只有35例患者（34.3%）需要非侵入性或侵入性机械通气支持，而67例患者（65.7%）在高流量鼻氧和易醒定位下成功治疗（p=0.001）。我们发现，在使用高流量鼻氧的最后一次俯卧位结束后，动脉血气参数和生化炎症标志物有统计学上的显着改善。
■俯卧位与高流量鼻氧结合的早期应用可能有助于通过改善氧合和生化炎症标志物来避免机械通气。
