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In this issue of JAMA Internal Medicine, Thompson and colleagues report the association of prone positioning with pulse oximetry in 25 awake, nonintubated patients with hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19).1 This study included patients who were hypoxemic (oxyhemoglobin saturation [Spo2] ≤ 93%) despite receiving 15 L/min oxygen by face mask and 6 L/min oxygen by nasal cannula and excluded patients who were unable to turn in bed without assistance and those determined to be in respiratory distress and requiring immediate intubation. The median (SE) improvement in oxygen saturation was 7% (1.2%) (95% CI, 4.6%-9.4%) after 1 hour of prone positioning. This study adds to a growing body of literature suggesting that prone positioning may improve oxygenation in patients with early acute respiratory distress syndrome (ARDS) prior to intubation.
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Sarma A, Calfee CS. Prone Positioning in Awake, Nonintubated Patients With COVID-19: Necessity Is the Mother of Invention. JAMA Intern Med. Published online June 17, 2020. doi:10.1001/jamainternmed.2020.3027
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