Abstract
The coronavirus disease (COVID-19) pandemic has brought the Italian National Health System to its knees. The abnormally high influx of patients, together with the limited resources available, has forced clinicians to make unprecedented decisions and provide compassionate treatments for which little or no evidence is yet available. This is the case for the use of noninvasive positive pressure ventilation and continuous airway pressure ventilation, combined with prone position in patients with COVID-19 and acute respiratory distress syndrome treated outside of intensive care units. In our article, we comment on the evidence available, so far, and provide a brief summary of data collected at our health institution in Piedmont, Italy.
Highlights
The coronavirus disease (COVID-19) pandemic has brought the Italian National Health System to its knees
The same benefits should apply to awake patients, the use of Prone positioning (PP) in non-intubated patients has seldom been described before the COVID-19 outbreak.[1,2,3,4]
As the pandemic continues its spread across the globe, the shortage of ventilators and intensive care units (ICUs) beds is driving clinicians to increasingly use PP outside of ICUs in an attempt to avoid or delay endotracheal intubation.[5,6]
Summary
The coronavirus disease (COVID-19) pandemic has brought the Italian National Health System to its knees. Prone positioning (PP) improves oxygenation and decreases mortality in intubated patients with acute respiratory distress syndrome (ARDS). Sartini et al.[5] have recently published a small case series of COVID-19-positive patients with mild-to-moderate ARDS treated with noninvasive ventilation (NIV) and PP, reporting that respiratory parameters improved after pronation.
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