Awake Prone Position to Reduce Ventilation Inhomogeneity in COVID-19 Acute Respiratory Failure (ProneSpontCov)

Public Assistance-Hospitals of Marseille (AP-HM)

Status: Completed

Conditions: Respiratory Failure

Treatments: Other: physiological effects of awake prone position in COVID 19 patients

Study type: Interventional

Funder types: Other

Identifiers

NCT04632602

2020-17

Details and patient eligibility

About

Evaluation of awake prone position on ventilation inhomogeneity in COVID-19 associated respiratory failure.

Full description

Awake prone position has been proposed as an additional treatment to alleviate hypoxemia during COVID-19 acute respiratory failure and potentially to avoid in some case tracheal intubation and invasive ventilation. Potential mechanism is improvement of ventilation: perfusion mismatch through redistribution of ventilation to the dorsal part of the lungs where perfusion is prominent. Electrical impedance tomography (EIT) is a non-invasive functional lung imaging of distribution of ventilation. Therefore, we aim to assess EIT on lung ventilation inhomogeneity during supine and prone position in COVID-19 patients.

Enrollment: 20 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• more than 18 Years (Adult, Older Adult)
• Confirmed COVID-19 (positive SARS-CoV-2 RT-PCR at nasopharyngeal swab)
• Acute respiratory failure with 100 < PaO2:FiO2< 300 mmhg
• Spontaneous ventilation with standard oxygen supply or high flow humidified oxygen
• Written informed consent of the patient

Exclusion criteria

• Contra-indication to prone position including pregnancy
• Presence of pacemaker
• Severe hypoxemia with PaO2/FiO2 < 100 mmHg
• Evidence of clinical signs of respiratory distress with high probability of intubation in the next two hours

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Single Blind

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20 participants in 2 patient groups

patients in prone position followed by dorsal decubitus

Other group

Description:

patients will be randomized on the order of position, either supine then prone, either prone then supine. Each period will last at least 2 hours.

Treatment:

Other: physiological effects of awake prone position in COVID 19 patients

dorsal decubitus followed by prone decubitus

Other group

Description:

patients will be randomized on the order of position, either supine then prone, either prone then supine. Each period will last at least 2 hours.

Treatment:

Other: physiological effects of awake prone position in COVID 19 patients