Official Title
Study of the Feasibility and Usefulness of the Prone Position in Patients With Respiratory Distress From Covid-19 Not Intubated, in Spontaneous Breath in Oxygen Therapy or Cpap
Brief Summary

The prone position during mechanical ventilation in patients with Acute Respiratory Distress Syndrome (ARDS) is able to improve oxygenation and thus reduce mortality. The objective of the study is to evaluate the ability of the prone position to increase the oxygenation of the patient with SARS-cov-2 pneumonia.

Detailed Description

BACKGROUND:



It has been shown that the prone position (PP) during mechanical ventilation (VM) in patients

with Acute Respiratory Distress Syndrome (ARDS) is able to improve oxygenation and thus

reduce mortality.



The reduced mortality, however, is not only caused by an increase in oxygen, but also by the

ability of the PP to reduce the damage associated with mechanical ventilation (VILI).



Studies show that the benefits of PP are also present in non-intubated patients; the PP

prevents the need for intubation and the consequent risk deriving from the procedure itself

and from the predisposition to develop superinfections (VAP).



Moreover, a reduction in the need for intubation and therefore hospitalization in the ICU

would be particularly useful in a context of great health emergency with limited resources.



The objective of the study is to value the ability of the prone position to increase the

oxygenation of the patient with SARS-cov-2 pneumonia as a lung recruitment index.



STUDY DESIGN:



This is a monocentric study that will be conducted on all patients admitted to the Infectious

Diseases and UTIR units of the S. Gerardo Hospital in Monza with the diagnosis of related

COVID pneumonia requiring oxygen support or CPAP.



Sample size (n. Patients): 56



The duration of enrollment is estimated in 1 month. Patients will be monitored until

discharged from the hospital. The overall duration of the study is estimated to be 1 year

(including enrollment, follow up and data analysis).



The patient will be enrolled in the study when consent is obtained. The following data will

be collected:



- Patient registration



- Demographic and anthropometric data



- Comorbidity and lifestyle habits



- Hospitalization data



- Blood chemistry tests



- Ventilation parameters



After 10 minutes and at the end of pronation, the feasibility of pronation and ventilation

parameters will also be assessed.



STATISTICAL ANALYSIS:



Clinical data relating to enrolled patients will be analysed by means of descriptive

statistics on continuous quantitative variables using indicators chosen on the basis of the

distributional form. Categorical variables will be described in percentages. Hypotheses on

PaO2 / FiO2 performance will be verified through the T test for paired data if the

distributional form allows it or alternatively the Wilcoxon test will be used. In this case

we will proceed with a recalculation of the power study.

Active, not recruiting
SARS-COV2

Procedure: Prone position
The objective of the study is to value the ability of the prone position to increase the oxygenation of the patient with SARS-cov-2 pneumonia as a lung recruitment index; the PP also prevents the need for intubation and the consequent risk deriving from the procedure itself and from the predisposition to develop superinfections (VAP).
covid-19 pneumonia related patients
Other Name: PP

Eligibility Criteria

Inclusion Criteria: - Age> = 18 years old or II - patients with high proBNP - patients with COPD - contraindications evidenced by the physicians

Eligibility Gender
All
Eligibility Age
Minimum: 18 Years~Maximum: 75 Years
Countries
Italy

Giuseppe Foti, Prof.
Principal Investigator
ASST Monza-University Milano Bicocca

University of Milano Bicocca
NCT Number
Keywords
Covid-19
sars-covid-2