Coronavirus Infection Clinical Trial
Official title:
Prone Positioning in Spontaneously Breathing Nonintubated Covid-19 Patient: a Pilot Study (ProCov)
The prone position consists of placing the patient on his or her stomach with the head on the side, during sessions lasting several hours a day and could help spontaneous ventilate the patient.
SARS-CoV-2 is an RNA virus whose tropism for the respiratory system is responsible for many
cases of acute respiratory failure. This can lead to acute respiratory distress syndrome
(ARDS) requiring orotracheal intubation and mechanical ventilation. The prone position is a
validated intensive care technique in the treatment of ARDS in mechanically ventilated
patients. Performing prone position sessions improves patient oxygenation by optimizing the
ventilation/perfusion ratios of the posterior areas of the lungs.
There is limited data in the literature on the ventral decubitus in spontaneous ventilation.
They are mainly case series or retrospective studies. In the case of the SARS-CoV-2 epidemic,
we are seeing patients with posterior lung involvement who may benefit from prone position
sessions prior to mechanical ventilation. This maneuver, usually done in an
intubated-ventilated-curarized patient, will be done in our spontaneous ventilation study in
a conscious patient.The patient will then be placed in prone position with the help of
physiotherapists so that the patient is correctly positioned.
The maneuver and the clinical monitoring of the patient's tolerance to the prone position
will be done under medical and paramedical supervision, including monitoring of saturation
during and after the procedure. A polygraph will also be installed on the patient in order to
monitor the patient's position (on the back vs. on the stomach), saturation and heart rate
during the entire prone position session. An arterial gasometry will be performed before the
patient is placed in the prone position, one hour after and after returning to the supine
position.
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