Effects of self-prone positioning method on oxygen saturation and
incidence of intubation in COVID-19 patients
Abstract
Study Objective: The purpose of this study was to determine the effects
of self-prone positioning on oxygenation in COVID-19 positive patients
utilizing supplemental oxygen and incidence of intubation. Method: A
one-year observational cohort pilot study at a major inner-city hospital
to evaluate self-proning on independent COVID-19 positive patients.
Qualified patients 18 years of age or older were recruited based on
inclusion and exclusion criteria. Data collection included vital signs
and timing for body position changes, and results were analyzed using
descriptive and inferential statistics. Results: Between April 2020 and
May 2021, 93 COVID-19 enrolled patients engaged in stomach or lateral
self-prone positioning. Eighty-four percent (n=78) of the population did
not require intubation, whereas 16% (n=15) were intubated during their
hospital stay. SpO2 means were determined for each population and prone
position: Non-intubated (stomach) - before proning 93% (IQR 4) and
during proning 95% (IQR 3); (lateral) before proning 92% (IQR 4) and
during proning 93% (IQR 4). Intubated (stomach) - before proning 90%
(IQR 7) and during proning 95% (IQR 4); (lateral) before proning 92%
(IQR 5) and during proning 95% (IQR 5). Stomach proning significantly
increased oxygenation in the non-intubated (p <0.001) and
intubated (p 0.017) populations. Lateral proning significantly improved
oxygenation in the intubated population (p 0.002). Conclusion:
Self-proning in the independent COVID-19 positive patient on
supplemental oxygen was effective in improving SpO2 levels short-term.
Further controlled trial studies will elucidate the duration of proning
effects and reinforce its use as a noninvasive rescue intervention to
prevent intubation.