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Diagnostic Assessment of Respiratory and Hemodynamic Changes Related to Prone Position in COVID-19 Patients

Published online by Cambridge University Press:  01 September 2023

Laura López-Viñas Open the ORCID record for Laura López-Viñas [Opens in a new window] ,
Emilia Roy-Vallejo ,
Esmeralda Rocío-Martín ,
Elena de la Rosa Santiago ,
Enrique Zamora García ,
Jose María Galván-Román  and
Rybel Wix-Ramos
Laura López-Viñas*
Affiliation:
Neurophysiology Department, Fundación Jiménez Díaz University Hospital, Madrid, Spain
Emilia Roy-Vallejo
Affiliation:
Internal Medicine Department, La Princesa University Hospital, Madrid, Spain
Esmeralda Rocío-Martín
Affiliation:
Neurophysiology Department, La Princesa University Hospital, Madrid, Spain
Elena de la Rosa Santiago
Affiliation:
Neurophysiology Department, La Princesa University Hospital, Madrid, Spain
Enrique Zamora García
Affiliation:
Pneumology Department, La Princesa University Hospital, Madrid, Spain
Jose María Galván-Román
Affiliation:
Internal Medicine Department, La Princesa University Hospital, Madrid, Spain
Rybel Wix-Ramos
Affiliation:
Neurophysiology Department, La Princesa University Hospital, Madrid, Spain
*
Corresponding author: Laura López-Viñas, Email: lauralvinas@hotmail.com.
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Abstract

Objective:

To study the respiratory patterns and the hemodynamic variations related to postural changes in inpatients with coronavirus disease (COVID-19).

Methods:

This report is a prospective study in a cohort of inpatients admitted with COVID-19. We recruited 10 patients admitted to the hospital with moderate or severe COVID-19 who showed improvement in oxygen saturation with prone positioning. We performed cardiorespiratory polygraphy and hemodynamic evaluations by thoracic electrical bioimpedance.

Results:

We observed a median minimum oxygen saturation of 85.00% (IQR: 7.00) in the supine position versus 91.00% (IQR: 8.00) (P = 0.173) in the prone position. The airflow restriction in the supine position was 2.70% (IQR: 6.55) versus 1.55% (IQR: 2.80) (P = 0.383) in the prone position. A total of 36.4% of patients were classified as having a normo-hemodynamic state in the supine position, whereas 54.5% were classified in this group in the prone position (P = 0.668). A decrease in vascular resistance was observed in the prone position (18.2% of vasoconstriction) compared to the supine position (36.4% of vasoconstriction) (P = 0.871).

Conclusion:

This brief report describes the effects of prone positioning on respiratory and hemodynamic variables in 10 patients with moderate or severe COVID-19.

Keywords

airflow restrictionCOVID-19oxygen desaturationprone positioningvasoconstriction
Type
Brief Report
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e475
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health

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