The prone position strategy for patients with acute respiratory distress syndrome (ARDS) is simple and cost-effective from the first description on its use in patients with acute respiratory failure to improve hypoxemia. Different studies have investigated its safety and efficacy in various clinical settings, demonstrating that its early use in combination with non-invasive mechanical ventilation (NIV) or high-flow oxygen therapy can reduce intubation rate and mortality in ARDS. In the Coronavirus disease 2019 (COVID-19) pandemic, high-value medicine and resource optimization are critical.
Coronavirus disease 2019 (COVID-19) is a pandemic that has significantly challenged health
systems worldwide. Due to the large number of infections around the world, the implementation
of strategies to reduce the number of intubations and the need for invasive mechanical
ventilation becomes important. In addition to the inability of the Mexican health system to
respond, patients under invasive ventilation have not had a favorable survival outcome. Up to
97% mortality has been reported in patients requiring intubation. The exact cause of this
poor prognosis is not yet known. Early recognition of hypoxemic patients could help with the
results. It seems reasonable in these patients to perform procedures to improve the clinical
respiratory picture before intubation in less severe cases due to the aforementioned. Prone
patient placement during invasive mechanical ventilation is a widespread practice in the
management of severe ARDS of other etiologies. Currently, few attempts have been made to
implement the prone position in patients who spontaneously ventilate with supplemental
oxygen, high-flow nasal cannulas, or noninvasive mechanical ventilation. Taking into account
that it is a procedure that does not require additional infrastructure within the services
and does not represent an additional cost for its implementation, it becomes a valuable tool
in the context of COVID-19 where intubation is associated with high mortality and in a
Additionally, there are mechanical ventilator deficits in most hospitals. This work has
feasibility to be carried out because it will be carried out in critical areas that have
equipment and trained personnel for it in the different shifts, in addition to having
patients diagnosed with COVID-19.
Procedure: Prone position
Position of the patient in which he is face down, for an improvement in oxygenation
Inclusion criteria
- Patient records with the following characteristics:
- Patients over 18 years of age
- Patients of both genders
- Patients diagnosed with COVID-19 infection
- Patients admitted to hospital
- Complete file
Non-inclusion criteria • Patients who do not decide to participate in the study
Exclusion criteria
• Files not found.
Elimination criteria
- Files with incomplete data
- File with a voluntary discharge or transfer note.
Hospital Materno Celaya
Celaya, Guanajuato, Mexico
Hospital Santo Tomas
Querétaro City, Queretaro, Mexico
Hospital General San Juan del Rio
Querétaro City, Queretaro, Mexico
ISSSTE Hospital Regional Merida
Mérida, Yucatan, Mexico
Hospital General de Zona 48 San PEDRO Xalpa IMSS
Estado De México, Mexico
Hospital Fernando Quiroz Gutierrez
Mexico City, Mexico
Orlando R Perez Nieto, MD, Principal Investigator
Hospital General San Juan del Rio