The Down Side of Prone Positioning: The Case of a COVID-19 Survivor

Minh Quan Le, Richard Rosales, Lauren T Shapiro, Laura Y Huang
American Journal of Physical Medicine & Rehabilitation 2020 July 9
The coronavirus 2019 (COVID-19) pandemic has resulted in a surge of patients with acute respiratory distress syndrome (ARDS). Prone positioning may be used in such patients to optimize oxygenation. Severe infections may leave survivors with significant functional impairment necessitating rehabilitation. Those who have experienced prolonged prone positioning are at increased risk for complications not typically associated with critical illness. This case report describes the course and clinical findings of a survivor of ARDS due to COVID-19 who was prone positioned while in intensive care and subsequently admitted to an inpatient rehabilitation facility. Her related complications, as well as those described in the literature, are reviewed. Critical elements of a comprehensive rehabilitation treatment plan for those who have been prone positioned, including implementation of preventive strategies, as well as early recognition and treatment of related injuries, will be described.

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