The efficiency of prone positioning in a COPD female patient with acute respiratory failure

Introduction
Chronic obstructive pulmonary disease (COPD) is characterized by progressive impaired gas exchange in the lungs, which can lead to acute respiratory failure. Clinical trials showed that prone positioning (PP) has a positive effect on blood oxygenation and can decrease mortality. Although prone positioning in acute respiratory distress syndrome (ARDS) is generally associated with positive effects, the clinical response of the individual patient is hard to predict.

Aim
The study aimed to present a case study of a female patient with COPD hospitalized in an ICU due to acute respiratory failure, and to show the effectiveness of prone positioning during mechanical ventilation. The analysis of medical records (medical history, observation charts, tests results), observation of the patient, and monitoring of vital signs were carried out.

Case study
The patient with COPD experienced an exacerbation of symptoms with increased airway obstruction and hypoxaemia, followed by hypercapnia, which required the implementation of mechanical ventilation. Despite antibiotic therapy, mechanical ventilation, and treatment with glucocorticoids and bronchodilators, symptoms of respiratory failure with increasing obstruction persisted. During hospitalization, comprehensive treatment, nursing care, and rehabilitation were carried out. After implementing prone positioning for 4 consecutive days, 12-14 hours/day, a significant improvement in ventilation and gas exchange was achieved without complications associated with this positioning. This enabled the extubation of the patient and stabilization of her clinical condition.

Conclusions
Prone positioning was an effective element in treating the presented patient.