Proning practices before and after COVID

• Before COVID, proning was clearly underused
• Recommendation for proning by official ARDS guidelines are strong that severe ARDS should receive proning>12hr/day
• Anecdotally have seen more proning during COVID
• Full team is more comfortable and familiar with it – it’s less new, RT and nursing are used to it and ask about it, etc
• But what do the numbers show?

Comparing Prone Positioning Use in COVID-19 Versus Historic Acute Respiratory Distress Syndrome, CCE, May 2022

• Retrospective review of proning during COVID 2020-2021 or pre-COVID ARDS 2018-2019 at academic and community hospitals
• Proning initiated faster and more in COVID vs historic ARDS (58%!!! vs 9%)
• Practice sustained throughout the pandemic
• Time will show if things will change over time if COVID numbers continue to stay low