RT Journal Article
SR Electronic
T1 Self-Proning in COVID-19 Patients on Low-Flow Oxygen Therapy. A Cluster Randomised Controlled Trial
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00692-2020
DO 10.1183/23120541.00692-2020
A1 Aileen Kharat
A1 Elise Dupuis-Lozeron
A1 Chloé Cantero
A1 Christophe Marti
A1 Olivier Grosgurin
A1 Sanaz Lolachi
A1 Frédéric Lador
A1 Jérôme Plojoux
A1 Jean-Paul Janssens
A1 Paola M. Soccal
A1 Dan Adler
YR 2021
UL http://openres.ersjournals.com/content/early/2021/01/28/23120541.00692-2020.abstract
AB Rationale and objectives Prone positioning as a complement to oxygen therapy to treat hypoxemia in coronavirus disease (COVID-19) pneumonia in spontaneously breathing patients has been widely adopted, despite a lack of evidence for its benefit.To test the hypothesis that a simple incentive to self-prone for a maximum of 12 h per day would decrease oxygen needs in patients admitted to the ward for COVID-19 pneumonia on low-flow oxygen therapy.Methods Twenty-seven patients with confirmed COVID-19 pneumonia admitted to Geneva University Hospitals were included in the study. Ten patients were randomised to self-prone positioning and 17 to usual care.Measurements and Main Results Oxygen needs assessed by oxygen flow on nasal cannula at inclusion were similar between groups. Twenty-four hours after starting the intervention, the median oxygen flow was 1.0 L·min−1 (interquartile range, 0.1–2.9) in the prone position group and 2.0 L·min−1 (interquartile range, 0.5–3.0) in the control group (p=0.507). Median oxygen saturation/fraction of inspired oxygen ratio was 390 (interquartile range, 300–432) in the prone position group and 336 (interquartile range, 294–422) in the control group (p=0.633). One patient from the intervention group who did not self-prone was transferred to the high-dependency unit. Self-prone positioning was easy to implement. The intervention was well tolerated and only mild side-effects were reported.Conclusions Self-prone positioning in patients with COVID-19 pneumonia requiring low-flow oxygen therapy resulted in a clinically meaningful reduction of oxygen flow, but without reaching statistical significance.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Kharat has nothing to disclose.Conflict of interest: Dr. Supuis-Lozeron has nothing to disclose.Conflict of interest: Dr. Cantero has nothing to disclose.Conflict of interest: Dr. Marti has nothing to disclose.Conflict of interest: Dr. Grosgurin has nothing to disclose.Conflict of interest: Dr. Lolachi has nothing to disclose.Conflict of interest: Dr. Lador has nothing to disclose.Conflict of interest: Dr. Plojoux has nothing to disclose.Conflict of interest: Dr. Janssens has nothing to disclose.Conflict of interest: Dr. Soccal has nothing to disclose.Conflict of interest: Dr. Adler has nothing to disclose.