Table 2.
Summary of reports into conscious prone positioning in COVID-19 patients
| Authors | n | Intervention (respiratory device) | Setting | Outcome | Key results | Strengths | Limitations |
|---|---|---|---|---|---|---|---|
| Caputo et al, 202029 | 50 | Single episode of prone position for 5 minutes (Non-rebreathe mask or nasal cannula) |
ED (ARF) | Improvement in SpO2 from supine to prone | SpO2 increased from 84% to 94%* (FiO2 not altered) | Proves feasibility in acute setting Prone positioning was only intervention |
Oxygen delivery not optimised before intervention Short prone episode |
| Elharrar et al, 202030 | 24 | Single episode of prone positioning for as long as tolerated† (Nasal cannula n=16, facemask/HFNC n=8) |
Non-ICU (ARF) | Increase in PaO2 of ≥20% when in prone position | Six responded (PaO2 9.8 to 12.5 kPa, 95% CI 0.8–4.8)† | Measured response to re-supination 10-day follow up |
Only 28% met inclusion criteria Unclear who received HFNC Variable length of intervention |
| Sartini et al, 202031 | 15 | Evaluation of all prone episodes on a single day (duration of episodes 3 hours, IQR 1–6) (CPAP while in prone position) |
Non-ICU (ARDS) | Change in RR, SpO2 and PaO2/FiO2 when in prone position | All had significantly improved SpO2 and PaO2/FiO2 during prone position§ | Proves feasibility 14-day follow up |
Interventions combined Patients already receiving intervention for median 5 days prior Patients not included if had failed intervention prior to day of data collection |
ARF = acute respiratory failure; CPAP = continuous positive airway pressure; ED = emergency department; HFNC = high flow nasal cannula; ICU = intensive care unit; RR = respiratory rate. *p=0.001. †Four patients tolerating <1 hour, 15 tolerating for >3 hours. ‡Three participants maintained response when returned to supine. §p<0.001; however, exact figures not supplied.