Guidance for conscious proning

04 Dec 2020

The recent COVID-19 pandemic has seen the critical care community treating increasing numbers of patients with ARDS over recent weeks, with one Chinese study reporting the prevalence of hypoxic respiratory failure in these patients at around 19%. Approximately 5% of all COVID-19 patients will require mechanical ventilation on an intensive care unit, with a further 14% requiring oxygen therapy.

Internationally, observations of critical care clinicians treating these patients in critical care have reported that patients with moderate to severe ARDS appear to have responded well to invasive ventilation in the prone position, leading to prone ventilation being recommended in international guidelines for the management of COVID-19. This corroborates well with the findings of the PROSEVA trial; a recent meta-analysis and a Cochrane Systematic review, all of which support the early use of prone ventilation in patients with moderate to severe ARDS to improve oxygenation and reduce mortality when compared with conventional supine ventilation.