Effect of Prone Positioning As Modality for Improvement in Bedside Oxygen Saturation in Awake Non-Intubated COVID-19 Patients and Its Relationship With High Resolution CT Chest Severity Score

Abstract

Objective: To evaluate the effectiveness of awake proning on bedside oxygen saturation in non-intubated severe COVID-19 cases and its association with high-resolution CT chest severity score.

Study Design: Prospective observational study.

Place and Duration of Study: Pak Emirates Military Hospital Pakistan, from Jun to Jul 2020.

Methodology: This study was conducted on 150 laboratories confirmed SARS-CoV-2 infected cases with moderate to severe category pneumonia, requiring supplemental oxygen but not mechanical ventilation, admitted in the High Dependency Unit of the Military Hospital. Bedside oxygen saturation was recorded via pulse oximeter before and after proning of 10 minutes to evaluate whether oxygen saturation increased, decreased or remained the same post proning.

Results: Out of 150 patients, it was observed that 67 (45%) patients showed 2% increase of oxygen saturation over 10 minutes of proning, 48 (32%) patients showed an increase of 1% while 20 (13%) patients showed an increase of 3%. It was also observed that 13 (14.7%) patients out of 88 patients, with HRCT severity score of >50% showed an increase of 3% compared to 7 (11%) patients out of 62 patients with HRCT severity score of <50%.

Conclusion: At least 60% of the patients showed an improvement of 2% or more after 10 minutes of proning, which concluded that awake proning in non-intubated patients may help improve oxygen saturation.