Prone Position in Non-intubated Patients with COVID-19, a Useful Maneuver to Avoid Mechanical Ventilation: A Literature Review

Main Article Content

Juárez-Villa Daniel
Mora-Ruiz Pablo
Sáenz-Luna Carlos
Zavala-Jonguitud Luis
Olascoaga-Lugo Arturo
Flores Guillermo
Zepeda-Quiroz Iván

Abstract

The spectrum of coronavirus disease 2019 (COVID-19) ranges from asymptomatic to acute respiratory distress syndrome (ARDS). Prone position has been widely used in ARDS patients with mechanical ventilation and its benefits have been proven. This maneuver can be extrapolated to non-intubated patients with COVID-19, avoiding mechanical ventilation in some patients. Previous reports have demonstrated the benefits of this intervention.

Keywords:
Prone position, COVID-19, acute respiratory distress syndrome, SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

Article Details

How to Cite
Daniel, J.-V., Pablo, M.-R., Carlos, S.-L., Luis, Z.-J., Arturo, O.-L., Guillermo, F., & Iván, Z.-Q. (2020). Prone Position in Non-intubated Patients with COVID-19, a Useful Maneuver to Avoid Mechanical Ventilation: A Literature Review. Journal of Advances in Medicine and Medical Research, 32(12), 5-14. https://doi.org/10.9734/jammr/2020/v32i1230538
Section
Review Article

References

World Health Organization. Novel coronavirus – China; 2020.

Available:http://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/

(Accessed 02 May 2020)

Ren LL, Wang YM, Wu ZQ, Xiang ZC, Guo L, Xu t, et al. Identification of a novel coronavirus causing severe pneumonia in human: A descriptive study. Chin Med J. 2020;1-10.

DOI: 10.1097/CM9.0000000000000722

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Eng J Med; 2020.

DOI: 10.1056/NEJMoa2002032

World Health Organization. Situation Report – 168; 2020.

Available:https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200706-covid-19-sitrep-168.pdf?sfvrsn=7fed5c0b_2

(Accessed 07 Jul 2020)

World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID.19).

Available:https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf

(Accessed 02 May 2020)

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.

DOI: 10.1016/S0140-6736(20)30183-5

Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M, et al. Characteristics and outcomes of 21 critically ill patients with covid-19 in Washington State. JAMA. 2020;323(16):1612-1614.

DOI: 10.1001/jama.2020.4326

Scholten EL, Beitier JR, Prisk K, Malhtora A. Treatment of ARDS with prone positioning. Chest. 2017;151(1):215-224.

DOI: 10.1016/j.chest.2016.06.032

Guerin C. Prone ventilation in acute respiratory distress syndrome. Eur Respir Rev. 2014;23:249-257.

DOI: 10.1183/09059180.00001114

Piehl MA, Brown RS. Use of extreme position changes in acute respiratory failure. Crit Care Med. 1976;4(1):13-4.

DOI: 10.1097/00003246-197601000-00003

Guerin C, Reignier J, Richard JC, Beret P, Gacouin A, Boulian T, et al. Prone positioning in severe acute respiratory distress syndrome. N Eng J Med. 2013; 368(23):2159-2168.

DOI: 10.1056/NEJMoa1214103

Gattinoni L, Taccone P, Carlesso E, Marini JJ. Prone position in acute respiratory distress syndrome. Rationale, indications, and limits. Am J Respir Crit Care Med. 2013;188(11):1286-93.

DOI: 10.1164/rccm.201308-1532CI.

Kallet RH. A comprehensive review of prone position in ARDS. Respiratory Care November 2015;60(11):1660-1687.

DOI:https://doi.org/10.4187/respcare.04271.

Matthay MA, Zemans RL, Zimmerman GA, Arabi YM, Beitler JR, Mercat A, et al. Acute respiratory distress syndrome. Nat Rev Dis Primers 5, 19; 2019.

Available:https://doi.org/10.1038/s41572-019-0075-2.

Confalonieri M, Salton F, Fabiano F. Acute respiratory distress syndrome. Eur Respir Rev. 2017;26:160116.

Available:https://doi.org/10.1183/16000617.0116-2016

Lazzeri Ch, Peris A. The Kigali modification of the berlin definition: A new epidemiological tool for ARDS?. Journal of thoracic disease, 8(6), E443–E445.

Available:https://doi.org/10.21037/jtd.2016.03.84.

Mouret-Hernández UEG, Mendoza-Rodríguez M, López-González A, Cortés.Munguia A. Comparison of Berlin vs Kigali criteria for diagnosis of the acute respiratory insufficiency syndrome. Med Crit. 2019;33(5):221-232.

Vercesi V, Pisani L, van Tongeren PSI, Lagrand WK, Leopold SJ, Huson MMA, et al. External confirmation and exploration of the Kigali modification for diagnosing moderate or severe ARDS. Intensive Care Med. 2018;44(4):523-524.

DOI:10.1007/s00134-018-5048-5

Gattinoni L, Chiumello D, Rossi S. COVID-19 pneumonia: ARDS or not? Critical Care 24, 154; 2020.

Available:https://doi.org/10.1186/s13054-020-02880-z

Gattinoni L, Chiumello D, Carironi P, Busana M, Romitti F, Brazzi L, Camporota L. COVID-19 Pneumonia: Different respiratory treatments for different phenotypes. Intensive Care Med. Epub; 2020.

DOI: 10.1007/s00134-020-06033-2

Marini JJ, Hurford WE. Should early prone positioning be a standard of care in ARDS with refractory hypoxemia? Wrong question-reply. Respir Care. 2016;61 (11):1564–5.

DOI: 10.4187/respcare.04562

Bloomfield R, Noble DW, Sudlow A. Prone position for acute respiratory failure in adults. Cochrane Database Syst Rev. 2015;(11):CD008095.

DOI: 10.1002/14651858.CD008095.pub2.

Munshi L. Prone position for acute respiratory distress syndrome. A systematic review and meta-analysis. Ann Am Thorac Soc. 2017;14 (Supplement_4):S280-S288.

DOI: 10.1513/AnnalsATS.201704-343OT

Scaravilli V, Grasselli G, Castagna L, Zanella A, Isgrò S, Lucchini A, et al. Prone positioning improves oxygenation in spontaneously breathing nonintubated patients with hypoxemic acute respiratory failure: A retrospective study. J Crit Care. 2015;30(6):1390-4.

DOI: 10.1016/j.jcrc.2015.07.008.

Ding L, Wang L, Ma W and He H. Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS: A multi-center prospective cohort study. Critical care (London, England). 2020;24(1):28.

Available:https://doi.org/10.1186/s13054-020-2738-5

Pérez-Nieto OR, Guerrero-Gutiérrez MA, Deloya-Tomas E, Ñamendys-Silva SA. Prone positioning combined with high-flow nasal cannula in severe noninfectious ARDS. Crit Care 24. 2020;114.

Available:https://doi.org/10.1186/s13054-020-2821-y

Ghelichkhani P, Esmaeili M. Prone Position in Management of COVID-19 Patients; a Commentary. Arch Acad Emerg Med. 2020;8(1):e48.

Clinical Trials.gov. Orlando Rubén Pérez-Nieto. Awake Prone Positioning and Oxygen Therapy in Patients with COVID-19 (APRONOX).

Available:https://clinicaltrials.gov/ct2/show/NCT04407468?term=awake+prone+position&cond=Covid-19&draw=2&rank=2

(Accessed 26 June 2020)

Clinical Trials.gov. John Laffey. Awake Prone Positioning to Reduce Invasive VEntilation in COVID-19 Induced Acute Respiratory failurE (APPROVE-CARE).

Available:https://clinicaltrials.gov/ct2/show/NCT04347941.

(Accessed 02 May 2020)

Sun Q, Qiu H, Huang M, Yang Y. Lower mortality of COVID-19 by early recognition and intervention: experience from Jiangsu Province. Ann Intensive Care. 2020;10 (1):33.

DOI: 10.1186/s13613-020-00650-2

Caputo ND, Strayer RJ, Levitan R. Early Self‐Proning in Awake, Non‐intubated Patients in the Emergency Department: A Single ED’s Experience during the COVID‐19 Pandemic. Acad Emerg Med. Accepted Author Manuscript.

DOI: 10.1111/acem.13994

Elharrar X, Trigui Y, Dols AM, Touchon F, Martinez S, Prud’homme E, Papazian L. Use of Prone Positioning in Nonintubated Patients With COVID-19 and Hypoxemic Acute Respiratory Failure. JAMA.

DOI: 10.1001/jama.2020.8255

Dong W, Gong Y, Feng J, Bai L, Qing H, Zhou P, et al. Early Awake prone and lateral position in non-intubated severe and critical patients with COVID-19 in Wuhan: A respective cohort study. medRxiv. 2020.05.09. 20091454;

Available:https://doi.org/10.1101/2020.05.09.20091454

Xu Q, Wang T, Qin X, Jie Y, Zha L, Lu W. Early awake prone position combined with high-flow nasal oxygen therapy in severe COVID-19: A case series. Crit Care. 2020;24(1):250.

Available:https://doi.org/10.1186/s13054-020-02991-7

Bower G, He H. Protocol for awake prone positioning in COVID-19 patients: To do it earlier, easier and longer. Critical Care. 2020;24:371.

Available:https://doi.org/10.1186/s13054-020-03096-x

Emergency Department Critical Care (EMCrit). PulmCrit Wee- Proning the non-intubated patient; 2016.

Available:https://emcrit.org/pulmcrit/proning-nonintubated/

(Accessed 02 May 2020)

COVID19 Proning Protocol Nebraska Medicine.

Available:https://www.nebraskamed.com/sites/default/files/documents/covid-19/proning-protocol.pdf

(Accessed 02 May 2020)

Intensive Care Society Guidance for Prone Positioning of the Conscious COVID Patient; 2020.

Available:https://icmanaesthesiacovid-19.org/news/ics-guidance-for-prone-positioning-of-the-conscious-covid-patient-2020

(Accessed 02 May 2020)

Massachusetts General Hospital Prone Positioning for Non-Intubated Patients Guideline.

Available:https://www.massgeneral.org/assets/MGH/pdf/news/coronavirus/prone-positioning-protocol-for-non-intubated-patients.pdf

(Accessed 02 May 2020)

Intensive Care Society Guidance for Prone Position in Adult Critical Care 2019.

Available:https://www.ics.ac.uk/ICS/ICS/Pdfs/Prone_Position_Guidance_in_Adult_Critical_Care.aspx

(Accessed 02 May 2020)

Paiva, Kelly Cristina de Albuquerque, & Beppu, Osvaldo Shigueomi. Prone position. Jornal Brasileiro de Pneumologia. 2005;31(4):332-340.

Available:https://doi.org/10.1590/S1806-37132005000400011

Pelosi P, Brazzi L, Gattinoni L. Prone position in acute respiratory distress síndrome. European Respiratory Journal. 2002;20:1017-1028.

DOI: 10.1183/09031936.02.00401702.

Vollman KM..Prone positioning in the patient who has acute respiratory distress syndrome: The art and science. Crit Care Nurs Clin North Am. 2004;16(3):319-36. viii.

DOI: 10.1016/j.ccell.2004.04.007

Monares-Zepeda E, Guerrero-Gutiérrez MA, Meneses-Olguín C, Palacios-Chavarría A. Recommendations: Mechanical ventilation in anesthesia. What an intensivist has to tell to an anesthesiologist. Rev Mex Anestesiol, 2020;43(2):130-135.

DOI: 10.35366/92871.

Roca O, Messika J, Caralt B, García-de-Acilu M, Sztrymf B, Ricard JD, Masclans JR. Predicting success of high-flow nasal cannula in pneumonia patients with hypoxemic respiratory failure: The utility of the ROX index. J Crit Care. 2016;35:200-5.

DOI: 10.1016/j.jcrc.2016.05.022.

Roca O, Caralt B, Messika J, Samper M, Sztrymf B, Hernández G, et al. an index combining respiratory rate and oxygenation to predict outcome of nasal high-flow therapy. Am J Respir Crit Care Med. 2019;199(11):1368-1376.

DOI: 10.1164/rccm.201803-0589OC

Liu S, Shao Y, Chia T. The utility of high-flow nasal cannula ROX index in post-extubation respiratory failure. ERJ Open Research. 2020;6(suppl 4): 13.

DOI: 10.1183/23120541.RFMVC-2020.13

Patel M, Chowdhury J, Mills N, Marron R, Gangemi A, Dorey-Stein Zacariah, et al. ROX Index Predicts Intubation in Patients with COVID-19 Pneumonia and Moderate to Severe Hypoxemic Respiratory Failure Receiving High Flow Nasal Therapy. medRxic. 2020.06.30.20143867.

DOI:https://doi.org/10.1101/2020.06.30.20143867