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Review
. 2023 Oct;68(10):1449-1464.
doi: 10.4187/respcare.11227.

Prone Positioning for Patients With COVID-19-Induced Acute Hypoxemic Respiratory Failure: Flipping the Script

Jie Li  1 , Miguel Ibarra-Estrada  2 , Claude Guérin  3
Affiliations
Review

Prone Positioning for Patients With COVID-19-Induced Acute Hypoxemic Respiratory Failure: Flipping the Script

Jie Li et al. Respir Care. 2023 Oct.

Abstract

During the COVID-19 pandemic, prone positioning (PP) emerged as a widely used supportive therapy for patients with acute hypoxemic respiratory failure caused by COVID-19 infection. In particular, awake PP (APP)-the placement of non-intubated patients in the prone position-has gained popularity and hence is detailed first herein. This review discusses recent publications on the use of PP for non-intubated and intubated subjects with COVID-19, highlighting the physiological responses, clinical outcomes, influential factors affecting treatment success, and strategies to improve adherence with APP. The use of prolonged PP and the use of PP for patients undergoing extracorporeal membrane oxygenation are also presented.

Keywords: COVID-19; acute hypoxemic respiratory failure; awake prone positioning; prone positioning.

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Conflict of interest statement

Dr Li discloses relationships with Fisher & Paykel Healthcare, Aerogen, the Rice Foundation, the American Association for Respiratory Care, and Heyer. Dr Li is a section editor for Respiratory Care. The remaining authors have disclosed no conflicts of interest.

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