Prone Positioning Can Help Oxygenation in Nonintubated Patients with COVID-19

Prone positioning has been used for many years as an adjunct therapy for intubated patients with severe acute respiratory distress syndrome. Early in the COVID-19 pandemic, clinicians began using prone positioning for patients who were not yet intubated, with the hope of avoiding invasive mechanical ventilation (NEJM JW Gen Med Jul 1 2020 and JAMA 2020; 323:2336, 2338).

In this case series, investigators in New York City studied 29 patients with COVID-19 and acute hypoxemic respiratory failure (i.e., oxygen saturation, ≤93% and respiratory rate ≥30 breaths/minute) supported with 15 L/minute of oxygen by facemask and 6 L/minute of oxygen by nasal cannula. Patients were asked to lie on their stomachs for as much of 24 hours of the day as possi…