A Descriptive Study on Effectiveness of Prone Position on Prognosis of COVID-19 Patients in Selected Hospital

Background: Limited data are available on the use of prone position in intubated, invasively ventilated patients with Coronavirus disease-19 (COVID-19). Aim of this study is to investigate the use and effect of prone position in this population during the first 2020 pandemic wave. Methods: Retrospective, multicentre, national cohort study conducted [Dec 2021, Jan 2022 & Feb 2022] in Multidisplinary Critical Care Units (MDCCU) on adult patients needing invasive mechanical ventilation for respiratory failure caused by COVID-19. Clinical data were collected from the patient file. Information regarding the use of prone position was collected daily. The respiratory effects of the first prone position were studied in a subset of 60 patients. Patients were classified as Oxygen Responders if the PaO2/FiO2 ratio increased ? 20 mmHg during prone position and as Carbon Dioxide Responders if the ventilator ratio was reduced during prone position. Results: Out of 60 patients majority of the patients were aged between 30-40 years (38.4%), Hindus 46.6%, married 56.6%, secondary education 36.6%. With regard to other variables, 30% were diabetic, 28.4% of them were private employees, 51.6% of them had 3 or more children, 40% of them were admitted through ER, 43.4% of them stayed 20-30 days. Association between selected demographic variables and effectiveness of the prone position to increase the oxygenation of the patient with SARS-cov-2 pneumonia as a lung recruitment index was significant. the number of days the patient was on ventilator, that, majority of the patients were on ventilator greater than30 days 31.7%, on AC/PC mode 51.7%, plateau pressure before prone 40%, driving pressure before prone 38.4%. Plateau pressure after 24hrs of prone and driving pressure after 24hrs of prone nursing was 38.3%. The mean overall score of effectiveness was 13.2/57.39 with SD 2.93 with range of 7-20. There was statistical significant association between selected background variables and duration of stay (pless than0.05). However there was no statistically significant association between background variables and age, patient prognosis (pgreater than0.05). There was statistically significant association between selected background variables and duration of stay (pless than0.05). However there was statistically significant association between background variables and age, patient prognosis (pless than0.05). Conclusions: During the COVID-19 pandemic, prone position has been widely adopted to treat mechanically ventilated patients with respiratory failure. The majority of patients improved their oxygenation during prone position, most likely due to a better ventilation perfusion matching.