Background and objective: The ramifications of early lung protective measures and prone positioning on the ICU length of stay rates of patients admitted to the ICU with acute respiratory distress syndrome amid the COVID-19 pandemic constitute a pivotal examination. The study aims to identify the effect of early prone positioning on the length of stay, discharge rate, and number of tracheostomized patients in the ICU.
Methodology: This retrospective study was conducted on critically ill patients needing mechanical ventilation with lung protective strategy and admitted to the Intensive Care Units (ICUs) of Al-Azhar University Hospitals between March 2020 to April 2022. All patients in the study were interpreted retrospectively by examining the patient's records. Group A (n:39) included patients who had been early placed in prone positions within 24 hours of intubation, and Group B (n:31) included patients who had not been placed in prone positions. All patients received a lung protective strategy for ARDS. In both groups, PaO2, PaCo2, PH, SpO2, and PaO2/FiO2 ratio were checked initially and later every 24 hours for 6 days. All patients were evaluated for the total days of both hospital and ICU length of stay, number of successful discharges to home from the hospital, and the total number of tracheostomized patients.
Results: After prone positioning, lower SOFA and APACHE II scores were noticed in the prone group. No significant difference in the rate of discharge between the two groups. We observed a shorter non-significant hospital and ICU stays and more frequency of tracheostomy procedures in the prone group. We noticed a significant improvement in Po2/Fio2 ratios in the prone group starting from day 2 to day 6 as regards. We observed a significant improvement in Po2 in the prone group in comparison to the non-prone group.
Conclusions: Early prone positioning led to a significant improvement in both PaO2 and PaO2/FiO2 ratio with a non-significant decrease in both hospital and ICU length of stay. We collected data over consecutive six days. More researches are needed to check the effect of early prone positioning on patients' mortality.
Keywords: Prone, lung protective, ARDS, APACHI II, SOFA.
Key words: Prone, lung protective, ARDS, APACHI II, SOFA
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