Short and long-term complications due to standard and extended prone position cycles in CoViD-19 patients.
Alberto Lucchini, Vincenzo Russotto, Nicola Barreca and 9 others
PMID 34895799WHAT IT FOUND
Extended prone cycles in ventilated COVID-19 patients were associated with more pressure sores (51% versus 32%), but no increase in other recorded complications.
At three months, no pressure sore problems or overall muscle-strength differences were reported.
Key findings
01Extended pronation was associated with a higher prevalence of pressure sores due to prone positioning (51% versus 32%, p = 0.032).
02There were no statistically significant differences between standard and extended pronation cycles in the severe complications recorded.
03At three months, no patient reported pressure sore problems, and overall MRC and handgrip results did not differ significantly between groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
It was a single-centre retrospective study, so the groups were not randomly assigned and other differences between patients could explain the results. Data were collected during pandemic surges with reduced nurse-to-patient ratios and high workload, which may have made pressure sore detection incomplete. Extended pronation was more common during the second wave, when staffing and resources were lower, so the pressure sore difference may be influenced by context rather than cycle length alone. Only 58 patients attended the three-month follow-up, so complications in patients not seen cannot be excluded. The follow-up results include some lower-limb MRC grades below normal, so they do not show that every patient had normal strength.
Declared interests
No financial support was reported. The authors declared no competing financial interests or personal relationships.
The easy way to misread this
Do not read the three-month follow-up as showing that extended pronation is risk-free. Pressure sores were significantly more common with extended cycles, and only 58 patients were followed up.