Clinics (Sao Paulo). 2020;75:e2196.
A multidisciplinary approach to prevent and treat pressure sores in proned COVID-19 patients at a quaternary university hospital
Fabio de Freitas Busnardo
, Gustavo Gomes Monteiro, Rogério Rafael da Silva Mendes
, Laielly Abbas, Vitor Figueiredo Pagotto
, Cristina Camargo
, Maria José Carvalho Carmona
, Rolf Gemperli
DOI: 10.6061/clinics/2020/e2196
An estimated 10-15% of patients with respiratory disease resulting from coronavirus disease 2019 (COVID-19) develop acute respiratory failure and require intensive care (). In order to improve breathing patterns in patients with severe acute respiratory syndrome (SARS), prone positioning can make ventilation more efficient. Proning minimizes ventral alveolar distension and reduces dorsal alveolar collapse by decreasing the difference between dorsal and ventral transpulmonary pressure. It also prevents compression of the lungs, consequently improving blood perfusion and gas exchange ().
When indicated, proning should begin early (preferably within the first 24 hours) in patients who present with SARS and serious deterioration of gas exchange characterized as a ratio of the partial pressure of oxygen in arterial blood to the fraction of inspired oxygen (PaO2/FiO2) below 150 mmHg. Once patients are placed in the prone position, they must remain prone for at least 16 hours (up to 20 hours) before being returned to the supine position ().
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