Published in:
Open Access
01-12-2020 | SARS-CoV-2 | Research Letter
Early awake prone position combined with high-flow nasal oxygen therapy in severe COVID-19: a case series
Authors:
Qiancheng Xu, Tao Wang, Xuemei Qin, Yanli Jie, Lei Zha, Weihua Lu
Published in:
Critical Care
|
Issue 1/2020
Login to get access
Excerpt
Coronavirus disease 2019 (COVID-19) has rapidly spread around the world in the past 3 months and has now become a global public health crisis. The mortality of COVID-19 in some European cities exceeds 11%, and the fatality rate is up to 61.5% in critical patients, especially in mechanically ventilated patients [
1]. Once mild to moderate patients progress to critical illness, the incidence of septic shock, intubation, and myocardial injury increases significantly. Mechanical ventilation patients need more sedative, analgesic, and neuromuscular blocker drugs, which will affect the patient’s hemodynamic status and airway expectoration ability [
2]. Previous studies have confirmed that high-flow nasal cannula (HFNC) can reduce the endotracheal intubation rate and mortality in patients with respiratory failure [
3]. However, this therapy of COVID-19 cannot improve the pathophysiology of ventilation-perfusion defects and atelectasis, which can be proved by autopsies, i.e., small airways are blocked by mucus plugs [
4]. Awake prone position could improve the mismatch of ventilation-perfusion and open the atelectatic lungs by adequate sputum drainage. So far, the role of early awake prone position (PP) combined with HFNC therapy in the treatment of severe COVID-19 has not been reported. So, we conducted a retrospective observation study in three hospitals in Wuhu and Maanshan cities in Anhui Province. …