Nerve Compression Injuries After Prolonged Prone Position Ventilation in Patients With SARS-CoV-2: A Case Series.
Luigia Brugliera, Massimo Filippi, Ubaldo Del Carro and 11 others
PMID 33245939WHAT IT FOUND
Seven men treated with prolonged prone ventilation for severe pneumonia developed nerve injuries in arms or legs.
The cases included brachial plexus damage, ulnar nerve compression at the elbow, and peroneal nerve injury. All patients were male, and most had significant weight loss or risk factors for malnutrition.
Key findings
01All seven patients in the series were male.
02The nerve injuries varied in location and severity, including bilateral axillary/suprascapular lesions, ulnar neuropathies at the elbow, brachial plexopathies, and a lumbosacral plexopathy.
03All patients reported a low body mass index and risks of malnutrition according to the Malnutrition Universal Screening Tool.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a case series of only seven patients, all male, so it cannot establish how common these injuries are in the general population or in women. The study does not include a control group, so it is impossible to determine if prone positioning itself caused the injuries or if other factors like immobility, sedation, or weight loss were responsible. The authors suggest risk factors like male sex and malnutrition, but these are associations observed in a small group, not proven causes.
The easy way to misread this
Do not assume that prone positioning is the sole cause of these nerve injuries. The patients had multiple potential risk factors, including significant weight loss, malnutrition, and prolonged immobility, and the contribution of each factor cannot be separated in this small series.