Posicionamiento prono en pacientes con síndrome de distrés respiratorio agudo grave por COVID-19 en Cuidados Intensivos Adultos del Hospital de Clínicas: estudio descriptivo

Abstract

Objectives

To describe the evolution of patients with Severe Acute Respiratory Distress Syndrome (ARDS) due to COVID-19 who required mechanical ventilation and prone position.

Methods

Descriptive, retrospective, cross-sectional study.

Background

COVID-19 in its severe form presents ARDS and admission to intensive care unit (ICU) for ventilatory support. Prone position is a well-known technique, which consists of ventilating the patient in the ventral position, optimizing alveolar recruitment and thus improving the oxygenation of these patients.

Patients

Adults of both sexes admitted from August 2021 to August 2022 at ICU with a diagnosis of ARDS due to COVID-19 who received orotracheal intubation, mechanical ventilation and prone position as treatment.

Results

In this period, 214 patients with COVID-19 were admitted to the intensive care unit of the Hospital de Clínicas. Of these, 127 patients (59.3%) were on invasive mechanical ventilation and prone position, with improvement in PaO2/FiO2 in 85% of them. They presented non-infectious complications: 13 patients with facial sores, while 2 patients were accidentally extubated. Pneumonia occurred in 87 patients (68%), catheter infection in 12 (9.4%), 5 of which were associated with bacteremia. Bacteremia without a known portal of entry 35 (27.5%). The mortality was 51.18%.

Conclusions

In our study, 60% of the patients required prone position with improved oxygenation in 85% of them, with a low rate of complications associated.