Effects of prone and lateral position in non-intubated patients with 2019 Novel Coronavirus (COVID-19) pneumonia

Schifino, Gioacchino; Grauw, Arianna Johanna de; Daniele, Fabio; Comellini, Vittoria; Fasano, Luca; Pisani, Lara

doi:10.1016/j.pulmoe.2020.10.015

Cited by 13 publications

(14 citation statements)

References 22 publications

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“…The lateral position may also be associated with beneficial effects of gas exchange, especially in unilateral lesions [ 3 ]. Although there are studies evaluating the efficacy of both prone and lateral positioning [ 4 , 5 ], comparative studies on the efficacy of prone and lateral positions in HFNC patients with severe COVID-19 are rarely reported.…”

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confidence: 99%

Effects of prone and lateral positioning alternate in high-flow nasal cannula patients with severe COVID-19

Nan

Wang

et al. 2022

Crit Care

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confidence: 99%

Effects of prone and lateral positioning alternate in high-flow nasal cannula patients with severe COVID-19

Nan

Wang

et al. 2022

Crit Care

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“…We encouraged the patients to be in a prone position several hours a day. Based on the current recommendation, it has been theorized that adopting the prone position for conscious, non-intubated patients with COVID-19 helps improve oxygenation, reduce the need for invasive ventilation and potentially decrease mortality [ 23 ]. However, the patients can be in all suitable positions including prone, side-lying, upright, supine, and guided by the location of consolidations seen on imaging or found on examination [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…We provided respiratory rehabilitation according to the recently developed guidelines for patients with COVID-19 in the acute hospital setting [ 9 , 15 , 17 , 23 ]. We started interventions for the patients within 6 h of the baseline assessment.…”

Section: Methodsmentioning

confidence: 99%

“…At the beginning of the intervention, the patients were advised to avoid a supine position and maintain a prone position for at least 6–8 h (but not continuous) in a day. During the rest of the time, a lateral side-lying was maintained according to the current recommendation [ 23 ]. The intervention group received a range of breathing exercises in suitable positions [ 10 , 12 ].…”

Section: Methodsmentioning

confidence: 99%

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Effects of short-term breathing exercises on respiratory recovery in patients with COVID-19: a quasi-experimental study

Kader

Hossain

Reddy³

et al. 2022

BMC Sports Sci Med Rehabil

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Background Coronavirus disease 2019 (COVID-19) is a highly infectious respiratory tract disease. The most common clinical manifestation of severe COVID-19 is acute respiratory failure. Respiratory rehabilitation can be a crucial part of treatment, but data lack for patients with COVID-19. This study investigates the effects of short-term respiratory rehabilitation (i.e., breathing exercises) on respiratory recovery among non-ICU hospitalised patients with COVID-19. Methods This was a quasi-experimental, pre-and post-test study. The study recruited 173 patients hospitalised with moderate to severe COVID-19. All the patients received standardised care for COVID-19, and 94 patients in the intervention group also received the intervention of breathing exercises, which included breathing control, followed by diaphragmatic breathing, deep breathing, or thoracic expansion exercise, and huffing (forced expiratory technique) and coughing. Data on the mean values of peripheral oxygen saturation (SpO2), need for oxygen therapy (litre/min), respiratory rate (breaths/minute), and heart rate (beats/minute) and were collected at baseline, 4 days, and 7 days after the baseline assessment. Analysis of variance on repeated measures was applied to compare the mean value of outcome measures of all the time points. Results The mean (± SD) age of the intervention (69.6% men) and control group (62.1% men) were 50.1 (10.5) and 51.5 (10.4) years, respectively. At 4-day of follow-up, SpO2 (96.6% ± 1.9 vs. 90.7% ± 1.8, P < 0.001), need for oxygen therapy (0.8 ± 2.6 vs. 2.3 ± 2.9, P < 0.001), respiratory rate (20.5 ± 2.3 vs. 22.3 ± 2.5, P < 0.001), and heart rate (81.2 ± 9.5 vs. 89.2 ± 8.9, P < 0.001) improved in the intervention group compared to the control group. At 7-day follow-up, differences remained significant concerning the oxygen saturation and the need for oxygen therapy (P < 0.001) between the groups. Conclusions Our results indicate that breathing exercise, even for a short period, effectively improves specific respiratory parameters in moderate to severe COVID-19 patients. As a non-invasive and cost-effective respiratory rehabilitation intervention, breathing exercise can be a valuable tool for a health care system overwhelmed by the COVID-19 pandemic. These results should be considered preliminary until they are replicated in larger samples in different settings.

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“…The lateral position is known to be effective for improving oxygenation in monolateral pneumonia (100), but severe COVID-19 pneumonia seems to interest both lungs (101). Besides, lateral position in COVID-19 is applied (102,103). Despite the confirmed application of lateral position in COVID-19, its effects on possible superinfections and subsequent dysbiosis has not been investigated yet.…”

Section: Body Positionmentioning

confidence: 99%

The Role of Dysbiosis in Critically Ill Patients With COVID-19 and Acute Respiratory Distress Syndrome

et al. 2021

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In late December 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) quickly spread worldwide, and the syndrome it causes, coronavirus disease 2019 (COVID-19), has reached pandemic proportions. Around 30% of patients with COVID-19 experience severe respiratory distress and are admitted to the intensive care unit for comprehensive critical care. Patients with COVID-19 often present an enhanced immune response with a hyperinflammatory state characterized by a “cytokine storm,” which may reflect changes in the microbiota composition. Moreover, the evolution to acute respiratory distress syndrome (ARDS) may increase the severity of COVID-19 and related dysbiosis. During critical illness, the multitude of therapies administered, including antibiotics, sedatives, analgesics, body position, invasive mechanical ventilation, and nutritional support, may enhance the inflammatory response and alter the balance of patients' microbiota. This status of dysbiosis may lead to hyper vulnerability in patients and an inappropriate response to critical circumstances. In this context, the aim of our narrative review is to provide an overview of possible interaction between patients' microbiota dysbiosis and clinical status of severe COVID-19 with ARDS, taking into consideration the characteristic hyperinflammatory state of this condition, respiratory distress, and provide an overview on possible nutritional strategies for critically ill patients with COVID-19-ARDS.

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Effects of prone and lateral position in non-intubated patients with 2019 Novel Coronavirus (COVID-19) pneumonia

Cited by 13 publications

References 22 publications

Effects of prone and lateral positioning alternate in high-flow nasal cannula patients with severe COVID-19

Effects of prone and lateral positioning alternate in high-flow nasal cannula patients with severe COVID-19

Effects of short-term breathing exercises on respiratory recovery in patients with COVID-19: a quasi-experimental study

The Role of Dysbiosis in Critically Ill Patients With COVID-19 and Acute Respiratory Distress Syndrome

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