Prone during pandemic: development and implementation of a quality-based protocol for proning severe COVID-19 hypoxic lung failure patients in situationally or historically low resource hospitals.

ABSTRACT:

Background

Intermittent Prone Positioning (IPP) for Acute Respiratory Distress Syndrome (ARDS) decreases mortality. We present a program for IPP using expedient materials for settings of significant limitations in both overwhelmed established ICUs and particularly in low- and middle-income countries (LMICs) treating ARDS due to COVID-19 caused by SARS CoV-2.

Methods

The proning program evolved based on the principles of High Reliability Organizations (HROs) and Crew Resource Management (CRM). Patients with severe ARDS [PaO₂:FiO₂ ratio (PFr) ≤ 150 on FiO₂ ≥ 0.6 and PEEP ≥ 5 cm H₂O] received IPP. Patients were placed prone 16 h each day. When PFr was ≥ 200 for > 8 h supine IPP ceased. IPP used available materials without requiring ad

SUBMITTER: Astua AJ 

PROVIDER: S-EPMC7802981 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature