Modified Versus Conventional Prone Position for COVID-19 Patients in Adult Intensive Care Units: A Comparative Study.
Chen Huang, Wenwen Qi, Shuyuan Zhao and 8 others
PMID 40717033WHAT IT FOUND
A modified prone position had fewer pressure injuries (3 vs 9) and less eyelid and facial swelling than conventional prone positioning in 39 ICU patients with COVID-19 on non-invasive ventilation (19 modified, 20 conventional).
Oxygen saturation improved similarly in both groups.
Key findings
01Pressure injury was reported in 3 (25.0%) patients in the modified prone position group and 9 (75.0%) in the conventional prone position group (p = 0.044).
02Eyelid oedema occurred in 2 (10.5%) patients in the modified group and 9 (45.0%) in the conventional group (p = 0.031); facial oedema occurred in 5 (26.3%) and 13 (65%) respectively (p = 0.024).
03Daily continuous prone position time was 9.16 ± 3.01 hours in the modified group and 6.50 ± 2.14 hours in the conventional group (p = 0.003).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was retrospective and single-centre, with only 39 patients, so it cannot show that the modified position caused the lower complication rates. The authors state that potential biases cannot be entirely excluded. The sample was underpowered for the pressure injury outcome: post hoc power was 62%, and the authors state 50 patients would be needed for 80% power. The study could not separate whether the pressure injury difference was due to the U-shaped pillow or the bed position change. The study included only adults with COVID-19 receiving non-invasive ventilation without intubation in one emergency ICU, so it does not show what happens in other prone position populations.
Declared interests
The authors declared no conflicts of interest. Funding was named as the Shanghai Jiao Tong University School of Medicine Nursing Development Program and Shanghai Jiao Tong University School of Medicine Science.
The easy way to misread this
Do not conclude that the modified prone position improves oxygenation or prevents pressure injuries in all ICU patients. Oxygen saturation improved similarly in both groups, and the study was retrospective, small, underpowered, and could not separate the pillow from the position change.