LAUSR

Abstract This patient is a 67-year-old male who initially presented to our facility with acute respiratory failure secondary to COVID-19. Soon after arrival at our facility, the patient decompensated, developing severe ARDS requiring intubation and prone positioning to maintain adequate oxygenation. Over the next few days, the patient developed acute kidney injury with oliguria and severe volume overload. The vascular surgery service was consulted to obtain central venous access for emergent CRRT. Upon our exam, the patient was sedated and paralyzed in a rotating prone-positioning bed. He could not be positioned supine without immediately becoming hypoxic and decompensating. A 50-cm Permcath was inserted via left popliteal vein. This case report outlines a possible challenging scenario that may encounter vascular interventionist when dealing with COVID-19 patients with respiratory compromise in prone position.