EARLY PRONE POSITION FOR NON-INTUBATED COVID-19 PATIENTS WITH SEVERE HYPOXIA
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Date
2023-01-17
Authors
Najla Butros Abusahlia
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Abstract
Background: COVID-19 is an emerging infectious disease that was first recognized in Wuhan, China, and had then spread rapidly in the whole globe. Around 29 percent of patients with COVID-19 may develop ARDS. Previous research indicated that the average ratio of arterial oxygen tension to the fraction of inspired oxygen (PaO2/FiO2) can be increased by prone positioning and mortality in moderate to extreme ARDS can be decreased.
Aim: The study aims to evaluate the effect of early prone position on non-intubated COVID-19 patients with severe hypoxia.
Method: A Randomized Controlled Trial (RCT) design was used in this study. The population of the study was COVID-19 patients aged 18 years or more, with severe hypoxia. The sampling method was simple random sampling. Patient checklist was introduced in the present study for data collection.
Results: The gender were matched between experimental and control (25 (50%) and female (25 (50%)). The mean of experimental group was significantly higher than control group for Partial pressure of oxygen "PaO2" (mmHg) at 2 hours (79.6±17.6 vs. 67.9±12.3, t=3.87 & P< 0.001), Partial pressure of oxygen "PaO2" (mmHg) at 4 hours (87±19 vs. 66.9±14.3, t=5.969 & P< 0.001), Oxygen saturation "SpO2" at 0 minute (84.9±7.6 vs. 80.5±10.3, t=2.426 & P< 0.001), Oxygen saturation "SpO2" at 2 hours (91.3±6.2 vs. 83.4±8.7, t=5.202 & P< 0.001), Oxygen saturation "SpO2" at 4 hours (94.7±5.8 vs. 82.8±9.7, t=7.39 & P< 0.001) and total number of cycles: (13.9±10.8 vs. 0.4±3.1, t=8.44 & P< 0.001). Early prone positioning of non-intubated COVID-19 patients with severe hypoxia is associated with lowering complications and there is statistically significantly different between experimental group and control group regarding discharged to home, transfer to ICU department (60% vs. 8.0%, P <0.05) and death (0.0% vs. 8.0%, P<0.05). While there is not statistically significantly different in others complication resulting from prone positioning of the non-intubated COVID-19 patients with severe hypoxia.
Conclusion: Early prone position on non-intubated COVID-19 patients is associated with elevated partial pressure of oxygen "PaO2" (mmHg) at 2 hours, Partial pressure of oxygen "PaO2" (mmHg) at 4 hours, Oxygen saturation "SpO2" at 0-minute, Oxygen saturation "SpO2" at 2 hours, Oxygen saturation "SpO2" at 4 hours & Total number of cycles. As well as it associated with lowering respiratory rate "RR" (breath per minute) at 4 hours. However, early prone position on non-intubated COVID-19 patients is associated with decreased complications.
Key words: Prone position, non-intubated, COVID-19, hypoxia, Palestine.