The purpose of this study is to retrospectively review clinical data to determine whether awake proning improves oxygenation in spontaneously breathing patients with COVID-19 severe hypoxemic respiratory failure.
Critically ill patients with coronavirus disease 2019 (COVID-19) severely strained intensive
care resources in New York in April 2020. The prone position improves oxygenation in
intubated patients with acute respiratory distress syndrome. The investigators wanted to
study whether the prone position is associated with improved oxygenation and decreased risk
for intubation in spontaneously breathing patients with severe COVID-19 hypoxemic respiratory
failure. Awake prone positioning was implemented based on the health care provider decision.
Other: Awake proning
Prone positioning of awake, as tolerated, for up to 24 hours daily.
Inclusion Criteria:
- Consecutive patients admitted to the Columbia University step-down unit from April 6,
2020.
- Laboratory confirmed COVID-19 infection with severe hypoxemic respiratory failure
defined as respiratory rate ≥30 breaths/min and oxyhemoglobin saturation (SpO2) ≤93%
while receiving supplemental oxygen 6 L/min via nasal cannula and 15 L/min via
non-rebreather facemask.
Exclusion Criteria:
- Altered mental status with inability to turn in bed without assistance
- Extreme respiratory distress requiring immediate intubation, or oxygen requirements
less than specified in the inclusion criteria.
Columbia University Irving Medical Center
New York, New York, United States
Sanja Jelic, MD, Principal Investigator
Columbia University