Related Experiment Video

Updated: Oct 17, 2025

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
07:16

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient

Published on: November 30, 2022

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Role of proning and positive end-expiratory pressure in COVID-19

Kejal D Gandhi1, Munish Sharma2, Pahnwat Tonya Taweesedt2

  • 1Department of Medicine, Georgetown University/Medstar Washington Hospital Center, Washigton, DC 20010, United States.

World Journal of Critical Care Medicine
|October 7, 2021
PubMed

Insights

COVID-19 acute respiratory distress syndrome (ARDS) presents unique respiratory mechanics. Early proning improves oxygenation, and positive end-expiratory pressure (PEEP) should be individualized for better outcomes in critical care.

Area of Science:

  • Critical Care Medicine
  • Pulmonology
  • Infectious Diseases

Background:

  • The COVID-19 pandemic has caused significant morbidity and mortality, with many patients requiring intensive care unit (ICU) admission for acute hypoxic respiratory failure.
  • Acute respiratory distress syndrome (ARDS) is a common complication of COVID-19, but its respiratory mechanics may differ from typical ARDS.
  • Limited data and varying opinions exist regarding the optimal management of COVID-19 ARDS.

Purpose of the Study:

  • To provide insight into COVID-19 pathophysiology and its differences from typical ARDS.
  • To explain a distinct approach to mechanical ventilation for COVID-19 ARDS.
  • To critically analyze the roles of positive end-expiratory pressure (PEEP) and proning in ICU patients with COVID-19.

Main Methods:

  • Review of available data and clinical experience regarding COVID-19 ARDS.
  • Comparative analysis of respiratory mechanics in COVID-19 ARDS versus typical ARDS.
  • Critical evaluation of ventilation strategies, including PEEP titration and proning.

Main Results:

  • COVID-19 ARDS exhibits distinct pathophysiological characteristics compared to typical ARDS.
  • Early proning in COVID-19 patients has been observed to improve oxygenation.
  • Individualized titration of PEEP based on lung compliance is suggested for optimal management.

Conclusions:

  • Understanding the unique pathophysiology of COVID-19 ARDS is crucial for effective management.
  • Mechanical ventilation strategies, particularly proning and PEEP, require tailored approaches for COVID-19 patients.
  • Further research and data are needed to refine treatment protocols for COVID-19 ARDS.

Keywords:
Acute respiratory distress syndromeCOVID-19Intensive care unitPositive end-expiratory pressureProningVentilation management

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