TYPE: Abstract
TOPIC: Respiratory Care
PURPOSE: Proning and CPAP have been identified as effective management strategies for respiratory failure in patients with Covid-19. This service evaluation set out to determine if proning patients with Covid-19, already established on CPAP, lead to improvements in oxygenation and/or respiratory physiology.
METHODS: Proning was introduced in 25 patients with Covid-19, already established on CPAP (Mean PEEP = 7.5), without any other change in respiratory support. Oxygen saturations/requirements were recorded before, and after proning. Following which, oxygen delivered via CPAP was titrated to the lowest level required to meet target saturations. Analysis was performed using a paired samples t-test. Patients were also grouped according to their clinical trajectory (discharged to ward/intubated or died). Independent sample t-tests were used to identify whether differences between groups existed in the changes in oxygen saturations/requirements following proning.
RESULTS: When comparing patients grouped by eventual clinical trajectory, there was no significant difference in change in oxygen saturations or oxygen requirements between groups following proning.
CONCLUSIONS: Proning in addition to established CPAP in patients with Covid-19 significantly reduced oxygen requirements and significantly improved oxygen saturations. Proning did not significantly change clinical trajectory, however, this analysis was underpowered.
CLINICAL IMPLICATIONS: This small cohort has identified that proning is a useful adjunct to CPAP in improving immediate respiratory function in Covid-19 patients.
DISCLOSURE: Nothing to declare.
KEYWORD: COVID-19