In the setting of COVID-19 (coronavirus disease 2019)–associated moderate and severe acute respiratory distress, persistently hypoxemic patients often require prone positioning for >16 hours. We report facial pressure wounds and ear necrosis as a consequence of prone positioning in patients undergoing ventilation in the intensive care unit in a tertiary medical center in New York City.
AlhazzaniWMøllerMHArabiYM, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med. Published online March20, 2020. doi:10.1007/s00134-020-06022-5
2.
GuérinCReignierJRichardJ-C, et al; PROSEVA Study Group. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med. 2013;368(23):2159-2168.
3.
MunshiLDel SorboLAdhikariNKJ, et al. Prone position for acute respiratory distress syndrome: a systematic review and meta-analysis. Ann Am Thorac Soc. 2017;14:S280-S288.
4.
GattinoniLTognoniGPesentiA, et al; Prone-Supine Study Group. Effect of prone positioning on the survival of patients with acute respiratory failure. N Engl J Med. 2001;345:568-573.
5.
GirardRBaboiLAyzacLRichardJCGuerinC, Proseva trial. The impact of patient positioning on pressure ulcers in patients with severe ARDS: results from a multicentre randomised controlled trial on prone positioning. Intensive Care Med. 2014;40(3):397-403.
6.
GuerinCGaillardSLemassonS, et al. Effects of systematic prone positioning in hypoxemic acute respiratory failure: a randomized controlled trial. JAMA. 2004;292(19):2379-2387.
