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Posición prono en paciente no intubado con COVID-19 como maniobra para evitar la intubación / Prone position in non-intubated patient with COVID-19 as a maneuver to avoid intubation

Ivan Aguilar-Zúñiga, Jose Daniel Juarez-Villa, Pablo Mora-Ruíz, Luis Fernando Zavala-Jonguitud, Isaac Hernández-Castillo, Roberto de Lira-Barraza, Rubén Ramírez-Montes de Oca, Eduardo Barragán-Hernández, Guillermo Flores-Padilla

Resumen


Resumen

Introducción: la COVID-19 (del inglés Coronavirus Disease 2019) es una enfermedad que ha generado una pandemia, la cual ha afectado a todo el mundo, incluido México. Esta enfermedad puede presentarse desde una infección asintomática hasta síndrome de distrés respiratorio agudo (SDRA) grave. El objetivo del reporte de caso es mostrar la utilidad de la posición prono en pacientes no intubados.

Caso clínico: presentamos el caso de una mujer sin comorbilidades con COVID-19 y SDRA moderado, en quien se evitó la intubación tras la mejoría con la posición prono, evaluada por la saturación arterial de oxígeno por pulsioximetría y por la relación de la presión arterial de oxígeno y la fracción inspirada de oxígeno (PaO2/FiO2).

Conclusión: existe poca evidencia sobre esta maniobra terapéutica en pacientes despiertos. Sin embargo, puede ser de ayuda para mejorar la oxigenación y evitar la intubación en estos pacientes.

Abstract

Background: The COVID-19 (from Coronavirus Disease 2019) is a disease that has generated a pandemic that has affected the world, Mexico included. The spectrum of the disease ranges from asymptomatic infection to severe acute respiratory distress syndrome (ARDS). The objective of the case is to demonstrate the usefulness of the prone position in non-intubated patients.

Clinical case: We present the case of a woman without comorbidities with COVID-19 and moderate ARDS, in whom intubation was avoided after improvement with the prone position, as determined by arterial oxygen saturation by pulse oximetry and by the relationship of arterial oxygen pressure and the fraction of inspired oxygen (PaO2/FiO2).

Conclusion: There is scarce evidence of this therapeutic maneuver in awake patients. However, it can help to improve oxygenation and to avoid intubation in these patients.


Palabras clave


Infecciones por Coronavirus; Pandemias; Intubación: Síndrome de Dificultad Respiratoria del Adulto; Posición Prono / Coronavirus Infections; Pandemics; Intubation; Respiratory Distress Syndrome, Adult; Prone Position

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Referencias


 

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DOI: https://doi.org/10.24875/RMIMSS.M20000146

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