Role of Prone Position in Acute Hypoxemic COVID-19 Patients with Spontaneous Ventilation: A Randomized Controlled Study
Gad, A., El-Bahnsawy, M., Abd El-Ghafar, M., Ibrahim, I., Hamed, A. (2025). Role of Prone Position in Acute Hypoxemic COVID-19 Patients with Spontaneous Ventilation: A Randomized Controlled Study. EKB Journal Management System, 5(2), 18-33. doi: 10.21608/jicem.2025.427145
Alaa Mohamed Gad; Mohamed Gamal El-Bahnsawy; Mohamed Samir Abd El-Ghafar; Ibrahim Salah Eldin Ibrahim; Ahmed Mohammed Hamed. "Role of Prone Position in Acute Hypoxemic COVID-19 Patients with Spontaneous Ventilation: A Randomized Controlled Study". EKB Journal Management System, 5, 2, 2025, 18-33. doi: 10.21608/jicem.2025.427145
Gad, A., El-Bahnsawy, M., Abd El-Ghafar, M., Ibrahim, I., Hamed, A. (2025). 'Role of Prone Position in Acute Hypoxemic COVID-19 Patients with Spontaneous Ventilation: A Randomized Controlled Study', EKB Journal Management System, 5(2), pp. 18-33. doi: 10.21608/jicem.2025.427145
Gad, A., El-Bahnsawy, M., Abd El-Ghafar, M., Ibrahim, I., Hamed, A. Role of Prone Position in Acute Hypoxemic COVID-19 Patients with Spontaneous Ventilation: A Randomized Controlled Study. EKB Journal Management System, 2025; 5(2): 18-33. doi: 10.21608/jicem.2025.427145

Role of Prone Position in Acute Hypoxemic COVID-19 Patients with Spontaneous Ventilation: A Randomized Controlled Study

The Egyptian Journal of Intensive Care and Emergency Medicine
Volume 5, Issue 2, June 2025, Page 18-33  XML PDF (616.99 K)
Document Type: Original papers
DOI: 10.21608/jicem.2025.427145
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Authors
Alaa Mohamed Gad email 1; Mohamed Gamal El-Bahnsawyorcid 2; Mohamed Samir Abd El-Ghafar3; Ibrahim Salah Eldin Ibrahim4; Ahmed Mohammed Hamed5
1Assistant Lecturer of Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
2Lecturer of Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
3Assistant Professor of Anesthesiology and Surgical Intensive Care Department, Faculty of Medicine, Tanta University, Tanta, Egypt
4Professor of Chest Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
5Professor of Anesthesiology and Surgical Intensive Care Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Abstract
Background: The COVID-19 pandemic has prompted the need for novel treatments for acute hypoxemic respiratory failure. Prone positioning, a method previously reserved for severe ARDS, is now being explored for its benefits in non-intubated COVID-19 patients to improve oxygenation and potentially decrease the reliance on mechanical ventilation and ICU care. Aim: To evaluate if prone positioning alongside standard treatment enhances outcomes in acute hypoxemic COVID-19 patients, focusing on ICU admission, mechanical ventilation rates, oxygenation, hospital stay, and 28-day mortality compared to standard treatment alone. Material and Methods: This prospective, randomized controlled study involved 90 COVID-19 patients, divided into Group P (proning plus standard care, n=45) and Group S (standard care alone, n=45) admitted to Tanta University Hospitals. The study assessed the impact of prone positioning on ICU admission rates, mechanical ventilation use, oxygenation improvement, hospital stay duration, and 28th-day mortality. Results: Improvements in PaO2/FiO2 and SpO2/FiO2 ratios were significantly better in Group P after 24 hours and at the endpoint (p values 0.031 and 0.014; 0.028 and 0.035, respectively). Inflammatory markers and lymphocyte counts improved significantly in Group P at the endpoint. No significant difference was observed in mechanical ventilation use, cardiac arrest, or 28-day mortality between the groups. The incidence of ICU admission was significantly lower in group P than group S (P value =0.038). Conclusions: Prone positioning could be an effective adjunct therapy in the management of moderate COVID-19-induced respiratory failure, potentially alleviating ICU resource strain.
Keywords
Prone Position; Acute Hypoxemia; COVID-19; Spontaneous Ventilation
References
 

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