UC San Diego

Although proning is beneficial to acute respiratory distress syndrome, impressions vary about its efficacy. Some providers believe that paralysis is required to facilitate proning. We studied impact of paralysis on prone-induced gas exchange improvements and provider attitudes regarding paralytics.

Design

Observational.

Setting

University of California San Diego.

Patients

Intubated COVID acute respiratory distress syndrome patients.

Interventions

None.

Measurements and main results

1) Changes in Pao₂:Fio₂ and Spo₂:Fio₂ ratios before and after proning with and without paralytics, 2) adverse events during proning with and without paralytics, and 3) nurse and physician attitudes about efficacy/safety of proning with and without paralytics. Gas-exchange improvement with proning was similar with and without paralytics (with no serious adverse events). Survey results showed similar attitudes between nurses and physicians about proning efficacy but differing attitudes about the need for paralytics with proning.

Conclusions

Findings support use of proning and may help in design of randomized trials to assess paralytics in acute respiratory distress syndrome management.