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Facial Pressure Injuries from Prone Positioning in the COVID-19 Era

Sarah C Shearer1, Keon M Parsa1, Annemarie Newark2

  • 1Department of Otolaryngology/Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia, U.S.A.

The Laryngoscope
|January 3, 2021
PubMed

Insights

Facial pressure injuries are common in COVID-19 patients on prone positioning, with longer proning duration increasing risk. Enhanced preventative measures and early interventions are crucial for managing these injuries.

Area of Science:

  • Critical Care Medicine
  • Patient Safety
  • Dermatology

Background:

  • Prone positioning is a critical intervention for severe COVID-19 patients requiring mechanical ventilation.
  • Facial pressure injuries (FPIs) are a potential complication of prolonged prone positioning.
  • Understanding the incidence and risk factors for FPIs in COVID-19 patients is essential for improving care.

Purpose of the Study:

  • To determine the incidence of facial pressure injuries in COVID-19 patients undergoing prone positioning.
  • To characterize the anatomical locations of these facial pressure injuries.
  • To identify factors associated with the development of facial pressure injuries.

Main Methods:

  • Retrospective chart review of 263 intubated COVID-19 patients.
  • Data collected on proning status, duration, and presence/absence of facial pressure injuries.
  • Statistical analysis, including t-tests, to compare patient groups.

Main Results:

  • Nearly half (47.6%) of proned COVID-19 patients developed facial pressure injuries.
  • The most common sites were the cheek (84%) and ears (50%).
  • Average proning duration was significantly longer for patients with FPIs (6.79 days vs. 3.64 days).

Conclusions:

  • Facial pressure injuries occur with high incidence in COVID-19 patients requiring prone positioning.
  • Prolonged duration of prone positioning is a significant risk factor for developing FPIs.
  • There is a need for improved preventative strategies and timely interventions to mitigate FPIs.
Abstract

Keywords:
COVID-19Pronepressure injuriesprone positioningproning

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