Abstract

GONZALEZ RUIZ, Carlos Alejandro; RENTERIA DIAZ, Faustino Javier; MARTINEZ ZUBIETA, Ricardo  and  CERON DIAZ, Ulises Wilfrido. Impact of prone position on acute respiratory distress syndrome in patients with COVID-19 under invasive mechanical ventilation. Med. crít. (Col. Mex. Med. Crít.) [online]. 2020, vol.34, n.6, pp.326-329.  Epub Sep 19, 2022. ISSN 2448-8909.  https://doi.org/10.35366/98161.

At the end of 2019, a new species of coronavirus identified as SARS-CoV-2 emerged, with the ability to cause disease in humans, defined as COVID-19. As of March 2020, cases of SARS-CoV-2 pneumonia began to appear at the Hospital Español de México, some of these patients developed severe disease requiring invasive mechanical ventilation. A descriptive, cross-sectional, retrolective and analytical study of cases was conducted from May to August 2020, in patients admitted to the COVID intensive care area at said hospital. A sample of 42 patients was obtained, 32 (76%) men and 10 (24%) women, with severe pneumonia due to SARS-CoV-2 and refractory hypoxemia with a picture of acute respiratory insufficiency syndrome (SIRA) from moderate (PaO2/FiO2 < 200) to severe (PaO2/FiO2 < 100), which required invasive mechanical ventilation and for refractory hypoxemia at least one event in the prone position. The minimum duration of each prone episode was at least 24 hours, with a minimum of one decubitus and prone events and a maximum of seven events, with a global average of 2.7 prone events. The maximum prone time per event was 36 continuous hours, with an average of 30.1 hours in the prone position. It was possible to establish that patients in the prone position presented an improvement regarding the oxygenation index (PaO2/FiO2) with a p < 0.01, unlike other characteristics such as PaO2 and PaCO2, where not enough evidence was found with regard to being a predictor of mortality and gravity.

Keywords : Kirby index (PaO₂/FiO₂); invasive mechanical ventilation; COVID pneumonia; SARS-CoV-2; SIRA moderate and severe; prone position.

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