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The purpose of this research and literature review is to compare the use of prone positioning and respiratory pharmacotherapeutics within hospitalized COVID-19 patients and the outcomes associated with each. A literature review was performed using the databases PubMed, Clinical Key, DynaMed, and CINAHL. A variety of key terms were used when searching. Studies chosen were retrospective reviews, a cross sectional study, an interventional study, and a pilot study. Articles within the last three years were utilized after exclusion criteria was applied. A total of thirteen articles were included within this project. The research shows that pulmonary vasodilators such as inhaled Nitric Oxide (iNO), Epoprostenol (iEpo), and Iloprost did improve oxygenation within COVID-19 patients. Nitric oxide was seen to have the greatest impacts but is not a first line choice due to cost and potential adverse effects. The research also showed that the addition of prone positioning to pulmonary vasodilators increased oxygenation and subsequently increased the PF ratios of the patients. Nitric oxide with prone positioning was seen to have the largest increase in PF ratios throughout the studies. Prone positioning was associated with an adverse effect of pressure ulcers, with most being on the head and face. The most common adverse effect with the use of iEpo was noted to be bleeding which was not life threatening. iNO was noted to have bleeding as well as methemoglobinemia as the most common adverse effects. Overall, further research needs to be performed with larger patient populations and more control over various factors that could influence the patient’s prognosis


Physician Assistant Studies

Degree Name

Master of Physician Assistant Studies (MPAS)

First Advisor

Metzger, Jay

Publication Date

Spring 2023

Proning vs. Respiratory Pharmacotherapeutics in Hospitalized COVID-19 Patients