Complications associated with prone positioning in mechanically ventilated COVID-19 patients: A multicentre, retrospective observational study.

Rollinson, Thomas C; McDonald, Luke A; Rose, Joleen W; Eastwood, Glenn M; Costa-Pinto, Rahul; Modra, Lucy J; Akinori, Maeda; Bacolas, Zoe; Anstey, James; Bates, Samantha; Bradley, Scott; Dumbrell, Jodi; French, Craig; Ghosh, Angaj; Haines, Kimberley J; Haydon, Tim; Hodgson, Carol L; Holmes, Jennifer; Leggett, Nina; McGain, Forbes; Moore, Cara; Nelson, Kathleen; Presneill, Jeffrey; Rotherham, Hannah; Said, Simone; Young, Meredith; Zhao, Peinan; Udy, Andrew; Serpa Neto, Ary; Chaba, Anis; Bellomo, Rinaldo

doi:10.1016/j.aucc.2024.09.002

Title

Complications associated with prone positioning in mechanically ventilated COVID-19 patients: A multicentre, retrospective observational study.

Publication Date

2024-10-14

Author(s)

Rollinson, Thomas C

McDonald, Luke A

Rose, Joleen W

Eastwood, Glenn M

Costa-Pinto, Rahul

Modra, Lucy J

Akinori, Maeda

Bacolas, Zoe

Anstey, James

Bates, Samantha

Bradley, Scott

Dumbrell, Jodi

French, Craig

Ghosh, Angaj

Haines, Kimberley J

Haydon, Tim

Hodgson, Carol L

Holmes, Jennifer

Leggett, Nina

McGain, Forbes

Moore, Cara

Nelson, Kathleen

Presneill, Jeffrey

Rotherham, Hannah

Said, Simone

Young, Meredith

Zhao, Peinan

Udy, Andrew

Serpa Neto, Ary

Chaba, Anis

Bellomo, Rinaldo

Subject

ARDS

COVID-19

Complications

Pressure Injuries

Prone positioning

Type of document

Journal Article

OrcId

#PLACEHOLDER_PARENT_METADATA_VALUE#

DOI

10.1016/j.aucc.2024.09.002

Abstract

Prone positioning is commonly applied to improve gas exchange in mechanically ventilated patients with coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (ARDS). Whilst prone positioning is effective, specific complications may arise. We aimed to assess the prevalence of specific complications related to prone positioning in patients mechanically ventilated for COVID-19-related ARDS. Multicentre, retrospective observational study. Multi-centre observational study of mechanically ventilated patients with COVID-19-related ARDS admitted to intensive care units in Melbourne, Australia, from August to November 2021. Data on baseline characteristics, prone positioning, complications, and patient outcomes were collected. We assessed 553 prone episodes in 220 patients across seven sites (mean ± standard deviation age: 54 ± 13 years, 61% male). Overall, 58% (127/220) of patients experienced at least one prone-positioning-related complication. Pressure injury was the most prevalent (n = 92/220, 42%) complication reported. Factors associated with increased risk of pressure injury were male sex (adjusted odds ratio = 1.15, 95% confidence interval: [1.02-1.31]) and the total number of prone episodes (adjusted odds ratio = 1.11, 95% confidence interval: [1.07-1.15]). Device dislodgement was the next most common complication, occurring in 28 of 220 (13%) patients. There were no nerve or retinal injuries reported. Pressure injuries and line dislodgement were the most prevalent complications associated with prone positioning of patients mechanically ventilated for COVID-19. The risk of pressure injuries was associated with male sex and the number of prone positioning episodes.

Link

link

Citation

Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses 2024-10-14

Jornal Title

Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses

Austin Health

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