Objective To describe the characteristics of patients with acute respiratory distress syndrome (ARDS) due to bilateral COVID-19 pneumonia on invasive mechanical ventilation (IMV), and to analyze the effect of prone position >24 h (prolonged) (PPP) compared to prone decubitus <24 h (PP). Design A retrospective observational descriptive study was carried out, with uni- and bivariate analyses. Setting Department of Intensive Care Medicine. Hospital General Universitario de Elche (Elche, Alicante, Spain). Participants Patients with SARS-CoV-2 pneumonia (2020−2021) on IMV due to moderate-severe ARDS, ventilated in prone position (PP). Interventions IMV. PP maneuvers. Main variables of interest Sociodemographic characteristics, analgo-sedation, neuromuscular blockade (NMB), PD duration, ICU stay and mortality, days of IMV, non-infectious complications, healthcare associated infections. Results Fifty-one patients required PP, and of these, 31 (69.78%) required PPP. No differences were observed in terms of patient characteristics (gender, age, comorbidities, initial severity, antiviral and antiinflammatory treatment received). Patients on PPP had poorer tolerance to supine ventilation (61.29% vs 89.47%, p = 0.031), longer hospital stay (41 vs 30 days, p = 0.023), more days of IMV (32 vs 20 days, p = 0.032), longer duration of NMB (10.5 vs 3 days, p = 0.0002), as well as a higher percentage of episodes of orotracheal tube obstruction (48.39% vs 15%, p = 0.014). Conclusions PPP was associated with greater resource use and complications in patients with moderate-severe ARDS due to COVID-19.
【저자키워드】 Prone position, acute respiratory distress syndrome, SARS-CoV-2 pneumonia, Invasive mechanical ventilation, Decúbito prono, Decúbito prono prolongado, Neumonía por SARS-CoV-2, Ventilación mecánica invasiva, Prolonged prone position, Síndrome de distrés respiratorio agudo,