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Updated: Sep 3, 2025
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An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
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COVID-19 Lessons Learned: Prone Positioning With and Without Invasive Ventilation.
J Brady Scott1, Tyler T Weiss2, Jie Li2
1Department of Cardiopulmonary Sciences, Division of Respiratory Care, College of Health Sciences, Rush University, Chicago, Illinois. Jonathan_B_Scott@rush.edu.
Respiratory Care
|July 26, 2022
Summary
Prone positioning (PP) improved oxygenation and survival for COVID-19 patients on mechanical ventilation. Awake prone positioning (APP) and specialized teams also showed benefits, reducing intubation needs and complications.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Infectious Diseases
Background:
- Prone positioning (PP) is a key intervention for hypoxemic respiratory failure in mechanically ventilated patients.
- The COVID-19 pandemic accelerated the use and innovation of PP strategies.
- Understanding PP's role and optimizing its application are crucial for patient outcomes.
Purpose of the Study:
- To review the evidence on the efficacy and safety of prone positioning during the COVID-19 pandemic.
- To explore innovations such as awake prone positioning (APP) and multidisciplinary team approaches.
- To highlight methods for mitigating complications associated with prone positioning.
Main Methods:
- Systematic review of studies on prone positioning for COVID-19 patients.
- Analysis of data on oxygenation, survival, and intubation rates.
- Evaluation of the impact of awake prone positioning and team-based care.
Main Results:
- Prone positioning demonstrated benefits in improving oxygenation and survival, particularly for patients with positive responses.
- Awake prone positioning (APP) showed promise in enhancing oxygenation and potentially reducing the need for intubation.
- Multidisciplinary teams facilitated PP implementation and complication management during the pandemic.
Conclusions:
- Prone positioning is a valuable tool for managing hypoxemic respiratory failure in COVID-19.
- Awake prone positioning and specialized teams represent important advancements in respiratory care.
- A multidisciplinary approach is recommended to maximize benefits and minimize complications of prone positioning.
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