Prone position plexopathy: an avoidable complication of prone positioning for COVID-19 pneumonitis?
Josh King-RobsonEleanor BatesElisaveta SokolovRobert D M HaddenPublished in: BMJ case reports (2022)
Prone positioning is a mainstay of management for those presenting to the intensive care unit with moderate-to-severe acute respiratory distress syndrome due to COVID-19. While this is a necessary and life-saving intervention in selected patients, careful positioning and meticulous care are required to prevent compression and traction of the brachial plexus, and resultant brachial plexopathy. We describe two patients who developed a brachial plexus injury while undergoing prone positioning for management of COVID-19 pneumonitis. Both patients were diabetic and underwent prolonged periods in the prone position during which the plexopathy affected arm was abducted for 19 and 55 hours, respectively. We discuss strategies to reduce the risk of this rare but potentially disabling complication of prone positioning.
Keyphrases
- coronavirus disease
- end stage renal disease
- acute respiratory distress syndrome
- sars cov
- newly diagnosed
- ejection fraction
- chronic kidney disease
- healthcare
- peritoneal dialysis
- type diabetes
- palliative care
- randomized controlled trial
- rheumatoid arthritis
- pain management
- case report
- patient reported outcomes
- chronic pain
- systemic sclerosis
- intensive care unit
- quality improvement
- drug induced