■已知俯卧位可以降低患有中度至重度急性呼吸窘迫综合征(ARDS)的插管非COVID-19患者的死亡率。然而,缺乏强调清醒练习对COVID-19患者的影响的研究。我们的目标是对现有文献进行系统的回顾,以强调清醒下摆对插管需求的影响。COVID-19ARDS患者氧合和死亡率的改善。
■-对2个医疗数据库的系统搜索(PubMed,GoogleScholar)一直持续到2020年7月5日。13项研究符合纳入标准,210例患者纳入最终分析.
■-大多数患者年龄在50岁以上,男性占主导地位(69%)。面罩(26%)是用于氧气治疗的最常见界面。插管率和死亡率分别为23.80%(50/210)和5.41%(5/203)。苏醒调节导致氧合改善(11/13研究报告):SpO2,P/F比改善,7/13报告的PO2和SaO2(54%),5/13(38%),2/13(15%)和1/13(8%)的研讨。纳入的研究没有报告与俯卧位相关的主要并发症。
■易醒定位显示患有COVID-19相关呼吸系统疾病的患者的氧合有所改善。在不到30%的患者中观察到需要插管。因此,我们建议在患有COVID-19相关ARDS的患者中早期和频繁地进行治疗,然而,在得出任何明确的结论之前,需要进行随机对照试验。
UNASSIGNED: Prone positioning is known to reduce mortality in intubated non-COVID-19 patients suffering from moderate to severe acute respiratory distress syndrome (ARDS). However, studies highlighting the effect of awake proning in COVID-19 patients are lacking. We aim to conduct a systematic
review of the available literature to highlight the effect of awake proning on the need for intubation, improvement in oxygenation and mortality rates in COVID-19 patients with ARDS.
UNASSIGNED: - A systematic search of 2 medical databases (PubMed, Google Scholar) was performed until July 5, 2020. Thirteen studies fulfilled the inclusion criteria, and 210 patients were included for the final analysis.
UNASSIGNED: -Majority of the patients were above 50 years of age with a male gender predominance (69%). Face mask (26%) was the most common interface used for oxygen therapy. The intubation and mortality rates were 23.80% (50/210) and 5.41% (5/203) respectively. Awake proning resulted in improvement in oxygenation (reported by 11/13 studies): improvement in SpO2, P/F ratio, PO2 and SaO2 reported by 7/13 (54%), 5/13 (38%), 2/13 (15%) and 1/13 (8%) of the studies. No major complications associated with prone positioning were reported by the included studies.
UNASSIGNED: Awake prone positioning demonstrated an improvement in oxygenation of the patients suffering from COVID-19 related respiratory disease. Need for intubation was observed in less than 30% of the patients. Thus, we recommend early and frequent proning in patients suffering from COVID-19 associated ARDS, however, randomized controlled trials are needed before any definite conclusions are drawn.