Buikligging bij niet-beademde patiënten met covid-19

Ter discussie
17-02-2021
Sushil K. Badrising, Stephan P. Keijmel en Bram Kok

In Nederland wordt buikligging toegepast bij geïntubeerde IC-patiënten met zeer ernstige respiratoire insufficiëntie door covid-19. In Suriname is ervaring opgedaan met buikligging bij niet-beademde patiënten met dreigend respiratoir falen. Wat zijn die ervaringen en wat zijn argumenten vóór en tegen buikligging?

Awake prone positioning in covid-19 patients

Awake prone positioning in COVID-19 patients with respiratory failure has been applied worldwide. We hypothesize that early intervention of awake prone positioning in this patient category might avoid invasive mechanical ventilation and referral to ICU. We observed approximately 30 patients in Suriname in whom awake prone positioning was applied. Also, we reviewed the existing literature on awake prone positioning and discussion of the advantages and disadvantages of this relatively simple intervention. Prospective studies show an improvement in oxygenation, albeit sometimes temporary, but not a reduction in mortality rate or intubation. Mean duration of symptoms in these studies is 10-11 days. Awake prone positioning in COVID-19 patients with a longer duration of symptoms does not improve survival or need for intubation. No prospective studies on early prone position in COVID-19 patients have been conducted yet.

Conflict of interest and financial support: none declared.