Complications associated with prone positioning in mechanically ventilated COVID-19 patients: A multicentre, retrospective observational study

被引：1

作者：

Rollinson, Thomas C. ^{[1
,2
,3
,4
,15
]}

Mcdonald, Luke A. ^{[1
,2
]}

Rose, Joleen ^{[1
,2
]}

Eastwood, Glenn ^{[1
]}

Costa-Pinto, Rahul ^{[1
,3
]}

Modra, Lucy

Akinori, Maeda ^{[1
]}

Bacolas, Zoe

Anstey, James ^{[5
]}

Bates, Samantha ^{[3
,6
]}

Bradley, Scott ^{[8
,9
]}

Dumbrell, Jodi ^{[14
]}

French, Craig ^{[3
,6
]}

Ghosh, Angaj ^{[10
]}

Haines, Kimberley ^{[3
,6
,7
]}

Haydon, Tim ^{[11
]}

Hodgson, Carol L. ^{[3
,8
,9
,14
]}

Holmes, Jennifer ^{[11
]}

Leggett, Nina ^{[3
,6
,7
]}

McGain, Forbes ^{[3
,6
]}

Moore, Cara ^{[5
]}

Nelson, Kathleen ^{[9
]}

Presneill, Jeffrey ^{[5
]}

Rotherham, Hannah

Said, Simone ^{[10
]}

Young, Meredith ^{[8
]}

Zhao, Peinan ^{[14
]}

Udy, Andrew ^{[8
,14
]}

Neto, Ary Serpa ^{[1
,14
]}

Chaba, Anis ^{[1
]}

Bellomo, Rinaldo ^{[1
,3
,12
,13
,14
]}

机构：

[1] Austin Hlth, Dept Intens Care, Melbourne, Vic, Australia

[2] Austin Hlth, Dept Physiotherapy, Melbourne, Vic, Australia

[3] Univ Melbourne, Dept Crit Care, Melbourne, Vic, Australia

[4] Univ Melbourne, Dept Physiotherapy, Melbourne, Vic, Australia

[5] Royal Melbourne Hosp, Dept Intens Care, Melbourne, Vic, Australia

[6] Western Hlth, Dept Intens Care, Footscray, Vic, Australia

[7] Western Hlth, Dept Physiotherapy, Footscray, Vic, Australia

[8] Alfred Hlth, Dept Intens Care, Melbourne, Vic, Australia

[9] Alfred Hlth, Dept Physiotherapy, Melbourne, Vic, Australia

[10] Northern Hlth, Dept Intens Care, Epping, Vic, Australia

[11] St Vincents Hosp, Dept Crit Care Med, Melbourne, Vic, Australia

[12] Univ Melbourne, Data Analyt Res & Evaluat Ctr, Melbourne, Vic, Australia

[13] Austin Hosp, Melbourne, Vic, Australia

[14] Monash Univ, Australian & New Zealand Intens Care Res Ctr, Melbourne, Vic, Australia

[15] Inst Breathing & Sleep, Melbourne, Vic, Australia

来源：

AUSTRALIAN CRITICAL CARE | 2025年 / 38卷 / 02期

关键词：

Prone positioning; Complications; Pressure Injuries; COVID-19; ARDS; PRESSURE ULCERS; CRITICAL-CARE; IMPACT;

D O I：

10.1016/j.aucc.2024.09.002

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background and aims: Prone positioning is commonly applied to improve gas exchange in mechanically ventilated patients with coronavirus disease 2019 (COVID-19)erelated acute respiratory distress syndrome (ARDS). Whilst prone positioning is effective, specific complications may arise. We aimed to assess the prevalence of specific complications related to prone positioning in patients mechanically ventilated for COVID-19-related ARDS. Design: Multicentre, retrospective observational study. Methods: Multi-centre observational study of mechanically ventilated patients with COVID-19-related ARDS admitted to intensive care units in Melbourne, Australia, from August to November 2021. Data on baseline characteristics, prone positioning, complications, and patient outcomes were collected. Results: We assessed 553 prone episodes in 220 patients across seven sites (mean +/- standard deviation age: 54 +/- 13 years, 61% male). Overall, 58% (127/220) of patients experienced at least one prone-positioning-related complication. Pressure injury was the most prevalent (n 1/4 92/220, 42%) complication reported. Factors associated with increased risk of pressure injury were male sex (adjusted odds ratio = 1.15, 95% confidence interval: [1.02-1.31]) and the total number of prone episodes (adjusted odds ratio = 1.11, 95% confidence interval: [1.07-1.15]). Device dislodgement was the next most common complication, occurring in 28 of 220 (13%) patients. There were no nerve or retinal injuries reported. Conclusions: Pressure injuries and line dislodgement were the most prevalent complications associated with prone positioning of patients mechanically ventilated for COVID-19. The risk of pressure injuries was associated with male sex and the number of prone positioning episodes. (c) 2024 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

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页数：8

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