Authors

1Clara Diago Crisol, 2Katalin, Rubí Larrañaga, 3Silvia, Pérez Ortega

Position

1Máster en Enfermo crítico y emergencias y en Atención de Enfermería al enfermo cardiovascular (Universidad de Barcelona). Instituto Clínico Cardiovascular. Hospital Clínic de Barcelona (España)2Máster en Cuidados de enfermería al paciente crítico y en Atención de Enfermería al paciente con problemas cardiacos (Universidad Autónoma de Barcelona). Máster en Técnicas de perfusión y oxigenación extracorpórea (Universidad de Barcelona). Instituto Clínico Cardiovascular. Hospital Clínic de Barcelona (España)3Máster integral en Enfermo crítico y emergencias (Universidad de Barcelona). Doctoranda 4º en Ciencias de la Enfermería (Universidad Jaume I de Castellón). Instituto Clínico Cardiovascular. Hospital Clínic de Barcelona (España)

Contact address

Clara Diago Crisol. Instituto Clínico Cardiovascular. Hospital Clínic de Barcelona. C/ Villarroel, 170. 08036 Barcelona (España).

Contact email: clara.diagocrisol@gmail.com

Abstract

Objective: to describe the profile and evolution of patients with COVID-19 after postural change to pronation as part of their treatment for acute respiratory distress symptom (ARDS) at the Cardiovascular ICU of the Hospital Clínic in Barcelona which was reconverted to COVID ICU during the first wave of the pandemic.
Methodology: a cross sectional case series study, conducted between March and May 2020. The study included adults who had been positioned in pronation as part of their ARDS treatment. The following variables were collected through clinical record review: gender, age, medical history, ventilation and sedation, SAPS-II score, time of hospitalization, PAFI evolution (the ratio of arterial oxygen pressure to fractional inspired oxygen), complications and mortality. Descriptive statistics were used.
Results: in total, 44 patients were admitted, and 30% of them required pronation; 21 position changes were made in 13 patients, with 24 hours as median time. Of these patients, 69% were male, with 67.8 years as mean age, and 69% had a previous cardiopathy. The mean time with mechanical ventilation was 23.9 days, and the mean hospital stay was 45.1 days. There was an improvement in PAFI after pronation in all patients (initial = 132.5; during pronation = 232.6; final = 168.6). There was a 30.8% patient mortality during hospitalization at ICU. The most frequent complications were hemodynamic (n= 8).
Conclusion: the patient profile was a >65-year-old male with previous cardiopathy. There was a positive evolution in oxygenation. Mortality was not differentiated from other settings and it was lower than that estimated through the SAPSS-II score. There was a low proportion of complications.

Keywords:

Severe acute respiratory syndrome; nursing care; nursing process; resources management; critical care; critical care nursing; Intensive Care Units; coronavirus infections; Pneumonia; cross-sectional studies

Versión en Español

Título:

Evolución de pacientes con COVID-19 en pronación en una UCI reconvertida durante la primera ola