Prone positioning for ARDS patients-tips for preparation and use during the COVID-19 pandemic.
Ken Kuljit Singh ParharDanny J ZuegeKaren ShariffGwen KnightSean M BagshawPublished in: Canadian journal of anaesthesia = Journal canadien d'anesthesie (2020)
Many patients with coronavirus disease (COVID-19) will develop acute respiratory distress syndrome (ARDS). Prone positioning is an important non-pharmacologic strategy that should be considered for all invasively ventilated patients with moderate to severe ARDS (including those with COVID-19). Prone positioning offers several physiologic and clinical benefits, including improving hypoxemia, matching ventilation with perfusion, reducing regional hyperinflation, and improving survival. To safely offer prone positioning, appropriate training, simulation, and health system planning should be undertaken. In this review, we offer ten tips, based on the Alberta provincial prone positioning strategy during COVID-19, to safely implement and improve the appropriate use of prone positioning. We provide special considerations for its use during the COVID-19 pandemic or future respiratory pandemics.
Keyphrases
- acute respiratory distress syndrome
- coronavirus disease
- mechanical ventilation
- extracorporeal membrane oxygenation
- sars cov
- end stage renal disease
- respiratory failure
- respiratory syndrome coronavirus
- chronic kidney disease
- ejection fraction
- magnetic resonance imaging
- prognostic factors
- computed tomography
- peritoneal dialysis
- mass spectrometry
- early onset
- drug induced
- high resolution
- free survival