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Revista americana de medicina respiratoria
versión On-line ISSN 1852-236X
Resumen
CARNERO ECHEGARAY, Joaquín et al. Impact of the prone positioning in patients with severe COVID-19 in an acute care hospital in the Autonomous City of Buenos Aires. Rev. am. med. respir. [online]. 2023, vol.23, n.1, pp.16-24. ISSN 1852-236X. http://dx.doi.org/10.56538/ramr.cdim9893.
Introduction:
Prone positioning (PP) was the most used strategy in patients with CO VID-19 and refractory hypoxemia. Our objective was to describe the clinical character istics and evolution of patients with severe Covid-19 who required this procedure. Also to evaluate the relationship between risk factors and mortality.
Materials and method:
Observational retrospective descriptive study. Patients older than 18 years old with COVID-19 under mechanical ventilation (AVM) who required PP were included. Follow-up was carried out for 28 days. Complications associated with PP were recorded. Factors associated with mortality were analyzed using Cox regression.
Results:
Prone position was performed in 28 patients. The average age was 52.43 years and a median Charlson Score of 1 [0.00, 2.00]. The median number of days of AVM was 17.00 [IQR 13.00, 23.00] and 28.6% managed to be extubated. The median number of days in the ICU was 19.50 [IQR 14.00, 23.50] with a mortality of 53.6%. 35.7% needed 2 PD cycles with a predominant duration of 24-36 hours. 89.4% had pressure ulcers. Those who died spent fewer days in ICU (16 vs 28; p=0.006) and only one of them had managed to be extubated (1 vs 7, p = 0.011). No factors associated with mortality were found in the Cox regression.
Conclusion:
The study population consisted predominantly of males in an average age close to the fifth decade, with an approximate mortality of 50%. No statistically significant relationship was found between risk factors and mortality.
Palabras clave : COVID-19; Care units intensive; Prone position; Coronavirus SARS; Decubitus ulcers.