Manual vs Automatic Prone Positioning and Patient Outcomes in Acute Respiratory Distress Syndrome
| Autor: | Frank Guido-Sanz, Mary Lou Sole, Carrie Ogilvie, Lauren Morata, Rebecca Rich |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Thorax
ARDS medicine.medical_specialty Respiratory Distress Syndrome business.industry Standard treatment Discharge disposition General Medicine Acute respiratory distress Critical Care Nursing medicine.disease Patient Positioning 03 medical and health sciences Prone position 0302 clinical medicine 030228 respiratory system Emergency medicine Prone Position Medicine Humans In patient 030212 general & internal medicine business Complication Retrospective Studies |
| Zdroj: | American journal of critical care : an official publication, American Association of Critical-Care Nurses. 30(2) |
| ISSN: | 1937-710X |
| Popis: | Background Prone positioning is a standard treatment for moderate to severe acute respiratory distress syndrome (ARDS), but the outcomes associated with manual versus automatic prone positioning have not been evaluated. Objective To retrospectively evaluate outcomes associated with manual versus automatic prone positioning as part of a pronation quality improvement project implemented by a multidisciplinary team. Methods A retrospective, descriptive-comparative approach was used to analyze data from 24 months of a prone positioning protocol for ARDS. The study involved 37 patients, with 16 undergoing manual and 21 undergoing automatic prone positioning. Descriptive and nonparametric statistical analyses were used to evaluate outcomes associated with manual versus automatic prone positioning. Results Outcomes were similar between the 2 groups regarding time to initiation of prone positioning, discharge disposition, and length of stay. Manually pronated patients were less likely to experience interruptions in therapy (P = .005) and complications (P = .002). Pressure injuries were the most common type of complication, with the most frequent locations in automatically pronated patients being the head (P = .045), thorax (P = .003), and lower extremities (P = .047). Manual prone positioning resulted in a cost avoidance of $78 617 per patient. Conclusion Manual prone positioning has outcomes similar to those of automatic prone positioning with less risk of interruptions in therapy, fewer complications, and lower expense. Further research is needed to determine whether manual prone positioning is superior to automatic prone positioning in patients with ARDS. |
| Databáze: | OpenAIRE |
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