Tripod position as a novel adjunct clinical management of moderate to severe ARDS in COVID-19 patients: A case series and review
- Author:
Ryan T. Uy
1
,
2
;
Gerard Vincent A. Aguas
1
,
2
;
Portia Ann M. Aquino
1
,
2
;
Rhada E. Mendoza
1
,
2
;
Rey Benedict Raniaga
1
,
2
Author Information
- Publication Type:Case Reports
- Keywords: Tripod position; Dyspnea-relieving position
- MeSH: Prone Position; Respiratory Distress Syndrome; COVID-19
- From: Philippine Journal of Nursing 2021;91(1):103-107
- CountryPhilippines
- Language:English
-
Abstract:
Objective:The World Health Organization (WHO) recommends prone positioning for mechanically ventilated COVID-19 patients with Acute Respiratory Distress Syndrome (ARDS) to improve oxygenation. Subsequently, researchers facilitated the position to non-intubated COVID-19 patients as early management which showed significant improvement but with discerned limitations. Tripod position is explored as an alternative exhibiting promising results. This present study describes a case series of four COVID-19 patients with moderate to severe ARDS who demonstrated considerable breakthrough.
Methods:Four COVID-19 cases of moderate to severe ARDS were instructed to do tripod positioning as long as they can tolerate while under close supervision.
Results:An hour after assuming tripod position, all four patients presented a decrease in respiratory rate, increase in peripheral oxygen saturation, and increase in partial oxygen saturation in arterial blood gas. The assumed position was maintained by four patients without discomfort and was maintained with a mean of 12 - 20 hours per day.
Conclusions:Our findings confirmed that tripod position is advantageous to non-intubated COVID-19 patients with moderate to severe ARDS and may delay or prevent invasive mechanical ventilation. The position also manifested tolerance to extended duration which permitted time for the medical team to focus on managing their disease in its entirety. Nevertheless, certain aspects such as contraindication, side effects, and other adverse events that may occur have yet to be sufficiently clarified and investigated. - Full text:Tripod Position.pdf
