Arun Suresh

Abstract

Background: The study aimed to determine the outcome of prone position on oxygenation by studying the ROX index of the COVID 19 patients. Materials and Methods: This study was conducted as a prospective observational study on COVID 19 patients admitted in HDU and ICU requiring HFNC at Gandhi Medical College and Hamidia hospital Bhopal which is a tertiary COVID Centre, during the study period of 1 year. Detailed history was obtained and examination was done. Subjects who did not perform or did not allow prolonged proning were included as control. SpO2, RR, ROX index were assessed at baseline, at 30 min, hourly for 6 hours and at 12 hours to assess the improvement in oxygenation. Results: A total of 60 COVID-19 confirmed cases were enrolled with mean age of 57.22±8.9 years. The two groups were thus comparable with respect to baseline variables. Mean SpO2, RR and ROX index significantly improved following prone positioning. The need for invasive mechanical ventilation was significantly higher in group 2 (30.8%) as compared to group 1 (8.8%), (p Conclusion: Prone positioning is a simple and safe manoeuvre to improve oxygenation in COVID-19-associated hypoxemic respiratory failure. Prone positioning for longer duration reduce the work of breathing and improve the respiratory rate, SpO2 and FiO2 and ROX index. Also, prone positioning for prolonged duration is effective in obviating the need for invasive mechanical ventilation. Keywords: Prone position, ROX index, Mechanical ventilation, Oxygenation, SpO2, Recovery

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Abstract

Background: The study was conducted to assess the prevalence of hypokalemia in COVID 19 patients and its correlation with severity of infection and requirement of invasive mechanical ventilation. Materials and Methods: This was a prospective study conducted on COVID-19 patients admitted at tertiary care centre during the study period of 6 months. Detailed history was obtained and patients were subjected to routine and special investigations. Based upon serum potassium levels, patients were categorized into three groups i.e. normokalemia (>3.5 mmol/L), mild hypokalemia (3 to 3.5 mmol/L) and severe hypokalemia ( Results: The study was conducted on 100 patients with mean age of 66.6±12.5 years. Hypokalemia was present in 31% cases. Of them, 25% had mild and 6% cases had severe hypokalemia. Hypokalemia was significantly associated with shorter duration of symptoms; higher mean diastolic blood pressure; higher CURB 65 score; lymphocytopenia; raised serum ferritin, D-dimer and Trop T levels (p Conclusions: Hypokalemia is common in COVID 19 patients among Indian population. Hypokalemia is associated with severe illness and significantly affect clinical outcome. Hypokalemia is an independent predictor of risk of mechanical ventilation after adjusting for confounding variables.   Keywords: Hypokalemia, COVID 19, Invasive ventilation, Clinical outcome

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