Related Experiment Video

Updated: Sep 25, 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

3.6K

Impact of prone positioning on patients with COVID-19 and ARDS on invasive mechanical ventilation: a multicenter

Marieta C A Cunha1, Jociane Schardong, Natiele Camponogara Righi2,3

  • 1. Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil.

Jornal Brasileiro De Pneumologia : Publicacao Oficial Da Sociedade Brasileira De Pneumologia E Tisilogia
|April 27, 2022
PubMed

Insights

Most COVID-19 patients on mechanical ventilation responded positively to prone positioning. However, high mortality was observed, with age and disease severity predicting outcomes. Prone positioning improves oxygenation but requires careful patient selection.

Area of Science:

  • Critical Care Medicine
  • Respiratory Medicine
  • Infectious Diseases

Background:

  • Prone positioning is a key intervention for improving oxygenation in patients with Acute Respiratory Distress Syndrome (ARDS).
  • COVID-19 associated ARDS presents unique challenges, necessitating identification of factors influencing treatment response and prognosis.

Purpose of the Study:

  • To determine factors associated with a positive oxygenation response to prone positioning.
  • To identify predictors of mortality in critically ill COVID-19 patients undergoing prone positioning.

Main Methods:

  • Retrospective, multicenter cohort study of 574 COVID-19 patients on invasive mechanical ventilation.
  • Inclusion criteria: PaO2/FIO2 ratio < 150 mmHg, >18 years old.
  • Positive response defined as a 20 mmHg improvement in PaO2/FIO2 after the first prone session.

Main Results:

  • 72% of patients showed a positive oxygenation response to the initial prone positioning session.
  • Responders had lower Simplified Acute Physiology Score III (SAPS III)/SOFA scores and D-dimer levels.
  • Mortality rate was 69.3%. Predictors of mortality included age, time to first prone session, number of sessions, pulmonary impairment, and immunosuppression.

Conclusions:

  • Most COVID-19 patients benefit from prone positioning regarding oxygenation.
  • Predictors of oxygenation response include initial SAPS III and PaO2/FIO2 ratio.
  • High mortality underscores the severity of illness; age, disease progression, and comorbidities are critical mortality predictors.
Abstract

More Related Videos

Author Spotlight: Unraveling the Impact of Mechanical Ventilation on Diaphragm Function and Patient Outcomes05:51

Author Spotlight: Unraveling the Impact of Mechanical Ventilation on Diaphragm Function and Patient Outcomes

Published on: November 3, 2023

6.8K
Prone Lateral Minimally Invasive Retropleural Corpectomy Using a Rotatable Radiolucent Jackson Table04:57

Prone Lateral Minimally Invasive Retropleural Corpectomy Using a Rotatable Radiolucent Jackson Table

Published on: July 3, 2025

499

Related Concept Videos

Mechanical Ventilation II: Invasive Ventilation01:23

Mechanical Ventilation II: Invasive Ventilation

Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
291
Mechanical Ventilation III: Noninvasive Ventilation01:23

Mechanical Ventilation III: Noninvasive Ventilation

Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
268
Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
405
Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
360
Acute Respiratory Failure-I01:21

Acute Respiratory Failure-I

Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
365
Mechanical Ventilation I: Indication and Settings01:29

Mechanical Ventilation I: Indication and Settings

Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
1.2K