Prone position beneficial for non-intubated Covid patients with respiratory failure

Having non-intubated Covid-19 patients with severe respiratory failure lie on their stomachs can help to improve their oxygen levels.

These are the findings of a study published in the prestigious medical journal The Lancet following a clinical trial, coordinated by the University of Tours in France, that 42 medical centers in six countries, including Barcelona's Hospital del Mar and Vall d'Hebron hospitals, participated in.

Medical professionals have been aware of the benefits of placing intubated ICU patients with respiratory failure into a prone position for the past decade, but this is the first study demonstrating the technique's efficacy for those who are not on ventilators.

The technique "is simple, has no cost, and is effective," says Dr. Oriol Roca, Vall d'Hebron's ICU medical coordinator, as it helps lungs inflate more homogeneously and under less stress.

And not only does placing people into a prone position help them avoid complications associated with ventilator use, but it also frees up ventilators for patients who need them – during the first wave, in particular, ventilators were scarce as hospitals faced an unprecedented influx of patients in respiratory distress.

1,126 patients participated in the clinical trial, which took place from April 2020 to January 2021. Half of these people were in the control group, meaning they received the standard treatment, while the other half were placed on their stomachs for on average five hours per day.

46% of those in the control group either required intubation or died up to 28 days after joining the study, while only 40% of those in the experimental group did.

Within the experimental group, 17% of patients in a prone position for at least eight hours a day ended up requiring intubation or passed away, but 48% of those who spent less time on their stomachs did. Because of this, researchers believe the time patients spent on their stomachs could be related.