Awake prone positioning for COVID-19 patients at Eka Kotebe General Hospital, Addis Ababa, Ethiopia: A prospective cohort study

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Awake prone positioning for COVID-19 patients at Eka Kotebe General Hospital, Addis Ababa, Ethiopia: A prospective cohort study


JournalJournal of the Pan African Thoracic Society
Article typeJournal research article – Clinical research
Publication date – Apr – 2021
Authors – Yidnekachew Asrat, Dawit Kebede Huluka​, Nebiyu Getachew, Hiluf Abate Abule, Hiruy Araya, Bethelehem Tadesse, Negussie Deyessa, Deborah A. Haisch4 Neil W. Schluger, Charles B. Sherman
KeywordsAwake prone, covid-19, Ethiopia, ventilation
Open access – Yes
SpecialityAnaesthesia, Critical care
World region Eastern Africa
Country: Ethiopia
Language – English
Submitted to the One Surgery Index on May 2, 2021 at 3:36 am
Abstract:

OBJECTIVES:
The objectives of the study were to evaluate the benefit of awake prone positioning in COVID-19 patients hospitalized at Eka Kotebe General Hospital, Addis Ababa, Ethiopia.

MATERIALS AND METHODS:
Consecutive patients with COVID-19 who require supplemental oxygen to maintain oxygen saturation of ≥90% during the month of October 2020 were enrolled. Structured questionnaires were employed to collect data. Admission oxygen saturation was recorded for each patient before and after their first proning session. Analysis of descriptive and comparison statistics was done using SPSS version 25.

RESULTS:
A total of 61 patients were included in the study. The mean age (+SD) for the cohort was 55.4 (+16.9) years. The average duration of proning was 5+2.5 h/session and 8+6 h/day. The average oxygen saturation before proning was 89% (SD 5.2) and 93% (SD 2.8) 1 h after proning (P < 0.001); supplemental oxygen requirements significantly decreased with prone ventilation, before proning: FiO2 0.33 (+0.14) versus 1 h after prone ventilation: FiO2 0.31 (+0.13) (P < 0.001). Oxygen improvement with prone ventilation was not associated with duration of illness or total prone position hours. When assessed at 28 days after admission, 55.7% (n = 34) had been discharged home, 1.6% (n = 1) had died, and 42.6 (n = 26) were still hospitalized.

CONCLUSION:
Awake prone positioning demonstrated improved oxygen saturation in our oxygen requiring COVID-19 patients. Even though further studies are needed to support causality and determine the effect of proning on disease severity and mortality, early institution of prone ventilation in appropriate oxygen requiring COVID-19 patients should be encouraged.

OSI Number – 21074

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