Efficacy of awake prone position to avoid mechanical ventilation for patients with COVID-19
Leonardo Cordeiro de Souza, Daniel de Almeida Thiengo, Fernando da Franca Bastos de Oliveira, Clovis Jean Cruz Faria, Marcos David P. Godoy, Arthur Evangelista da Silva Neto, André Luiz da C. Serejo, Raphaela Cristinne Carvalho Cordeiro, Amarildo Abreu, Victor Ricardo S. Daher
Background: During the COVID-19 pandemic the application of awake prone position (PP) in subjects has been describing such as a new procedures in combating the acute hypoxemic. Aim: Evaluate the efficacy of the awake PP in patients with hypoxemic respiratory failure by COVID-19 to avoid mechanical ventilation (MV). Methods: a clinical study. The subjects who were showing signs of hypoxemic respiratory failure were divided into two groups: the intervention group receiving treatment with oxygen therapy plus awake PP, and the control group only oxygen therapy. The primary outcome was the success to avoid the MV, and secondary outcomes were complications, length of stay and mortality rate in the ICU. Results: Thirty-two subjects underwent the PP in the Intervention group, and 35 maintained the conventional treatment with the oxygen therapy in the control group. The mean of the clinical variables analyzed did not show difference when comparing the groups. The rate of need of invasive mechanical ventilation (60% vs. 41%, P=0.18) and death rate (29% vs. 13%, P=0.29) was higher in the control group; however statistical diferences not were found. In the Kaplan-Meyer curves, the awake PP presented a tendency of reduction in mortality rate (15%), P=0.29 and presented a tendency of increase (30%) successful to avoid MV, P=0.16. Conclusion: The present study despite demonstrating that a simple procedure seems to contribute with a success rate to avoid the mechanical ventilator, however we cannot affir
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