Prone Positioning in Critically Ill COVID-19 Patients

May 6, 2020COVID Literature Appraisal, Management

No study till date evaluated effectiveness of mechanical ventilation in prone position with conventional ventilation in critically ill COVID-19 patients. Mechanical ventilation in prone position was used in varied proportion of critically ill patients; up to 28% of patients required prone positioning in one series.Indications and clinical impact of prone positing have not been reported in these patients. One small study reported improvement in lung recruitability with prone positioning.


  1. Bhatraju PK, Ghassemieh BJ, Nichols M, et al. Covid-19 in Critically Ill Patients in the Seattle Region – Case Series [published online ahead of print, 2020 Mar 30]. N Engl J Med. 2020;10.1056/NEJMoa2004500. LINK
  2. Grasselli G, Zangrillo A, Zanella A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy [published online ahead of print, 2020 Apr 6]. JAMA. 2020;e205394. doi:10.1001/jama.2020.5394 LINK
  3. Pan C, Chen L, Lu C, et al. Lung recruitability in SARS-CoV-2 associated acute respiratory distress syndrome: A single-center, observational study [published online ahead of print, 2020 Mar 23]. Am J Respir Crit Care Med. 2020;10.1164/rccm.202003-0527LE. LINK
  4. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study Lancet Respir Med 2020[Epub ahead of print]. DOI: 10.1016/S2213-2600(20)30079-5 LINK


Management- Critical care-Prone positioning