Conscious Proning: An Introduction of a Proning Protocol for Nonintubated, Awake, Hypoxic Emergency Department COVID-19 Patients
Conscious Proning: An Introduction of a Proning Protocol for Nonintubated, Awake, Hypoxic Emergency Department COVID-19 Patients
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DOI：
10.1111/acem.14035
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发表时间：
2020-06-23
影响因子：
4.4
通讯作者：
Farmer, Brenna
中科院分区：
文献类型：
--
作者：
Jiang, Lynn G.;LeBaron, Johnathon;Farmer, Brenna
这种新型冠状病毒，或称新冠肺炎，已迅速成为一种全球大流行。新冠肺炎导致的发病率和死亡率的一个主要原因是日益恶化的缺氧，如果不治疗，可能会发展为急性呼吸窘迫综合征和呼吸衰竭。过去的工作发现，ARDS患者插管后的俯卧位具有生理上的好处，因为它促进了肺血流与通风的更好匹配，改善了分泌物清除，并重新招募了肺的依赖区域。我们创建了一个系统范围的多机构(纽约长老会医院企业)方案，将清醒的、未插管的急诊科患者置于卧位，怀疑或确诊为新冠肺炎。在这篇文章中，我们描述了背景文献和我们在我们机构护理具有呼吸道症状的高负担新冠肺炎病例时所采取的方法。
The novel coronavirus, or COVID-19, has rapidly become a global pandemic. A major cause of morbidity and mortality due to COVID-19 has been the worsening hypoxia that, if untreated, can progress to acute respiratory distress syndrome (ARDS) and respiratory failure. Past work has found that intubated patients with ARDS experience physiological benefits to the prone position, because it promotes better matching of pulmonary perfusion to ventilation, improved secretion clearance, and recruitment of dependent areas of the lungs. We created a systemwide multi-institutional (New York-Presbyterian Hospital enterprise) protocol for placing awake, nonintubated, emergency department patients with suspected or confirmed COVID-19 in the prone position. In this piece, we describe the background literature and the approach we have taken at our institution as we care for a high burden of COVID-19 cases with respiratory symptoms.