1. Adverse Events during Prone Positioning of Patients with COVID-19 during a Surge in Hospitalizations—Results of an Observational Study.
- Author
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Radovanović, Nataša, Krajnc, Mateja, Gorenjak, Mario, Strdin Košir, Alenka, and Markota, Andrej
- Subjects
ARTERIAL catheters ,RANDOM forest algorithms ,NASOENTERAL tubes ,DATA analysis ,RECEIVER operating characteristic curves ,LYING down position ,HOSPITAL care ,SCIENTIFIC observation ,BODY weight ,FISHER exact test ,RETROSPECTIVE studies ,HOSPITAL mortality ,URINARY catheters ,DISEASE prevalence ,DESCRIPTIVE statistics ,MANN Whitney U Test ,TRACHEOTOMY equipment ,LONGITUDINAL method ,ARTIFICIAL respiration ,CENTRAL venous catheters ,STATISTICS ,ADVERSE health care events ,CARDIOPULMONARY resuscitation ,CONFIDENCE intervals ,DATA analysis software ,MACHINE learning ,COVID-19 ,PRESSURE ulcers ,ALGORITHMS ,ADULTS - Abstract
This study aimed to determine the prevalence of adverse events in mechanically ventilated adults with COVID-19 who have undergone prone positioning. A total of 100 patients were included retrospectively; 60% were males, the mean age was 64.8 ± 9.1 years, and hospital mortality was 47%. In all, we recorded 118 removals of catheters and tubes in 66 patients; 29.6% were removals of a nasogastric tube, 18.6% of an arterial line, 14.4% of a urinary catheter, and 12.7% of a central venous catheter. Reintubation or repositioning of a tracheotomy tube was required in 19 patients (16.1%), and cardiopulmonary resuscitation in 2 patients (1.7%). We recorded a total of 184 pressure ulcers in 79 patients (on anterior face in 38.5%, anterior thorax in 23.3% and any extremity anteriorly in 15.2%). We observed that body weight (p = 0.021; β = 0.09 (CI95: 0.01–0.17)) and the cumulative duration of prone positioning (p = 0.005; β = 0.06 (CI95: 0.02–0.11)) were independently associated with the occurrence of any adverse event. The use of prone positioning in our setting was associated with a greater number of adverse events than previously reported. Body weight and cumulative duration of prone positioning were associated with the occurrence of adverse events; however, other factors during a COVID-19 surge, such as working conditions, staffing, and staff education, could also have contributed to a high prevalence of adverse events. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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