Prone positioning as an emerging tool in the care provided to patients infected with COVID-19: a scoping review

Marília Souto de Araújo, Marina Marisa Palhano Dos Santos, Carlos Jordão de Assis Silva, Rejane Maria Paiva de Menezes, Alexsandra Rodrigues Feijão, Soraya Maria de Medeiros, Marília Souto de Araújo, Marina Marisa Palhano Dos Santos, Carlos Jordão de Assis Silva, Rejane Maria Paiva de Menezes, Alexsandra Rodrigues Feijão, Soraya Maria de Medeiros

Abstract

Objective: to describe scientific evidence regarding the use of prone positioning in the care provided to patients with acute respiratory failure caused by COVID-19.

Method: this is a scoping review. PRISMA Extension for Scoping Reviews was used to support the writing of this study. The search was conducted in seven databases and resulted in 2,441 studies, 12 of which compose the sample. Descriptive statistics, such as relative and absolute frequencies, was used to analyze data.

Results: prone positioning was mainly adopted in Intensive Care Units, lasted from a minimum of 12 up to 16 hours, and its prescription was based on specific criteria, such as PaO2/FiO2 ratio, oxygen saturation, and respiratory rate. The most prevalent complications were: accidental extubation, pressure ulcer, and facial edema. Decreased hypoxemia and mortality rates were the main outcomes reported.

Conclusion: positive outcomes outweighed complications. Various cycles of prone positioning are needed, which may cause potential work overload for the health staff. Therefore, an appropriate number of trained workers is necessary, in addition to specific institutional protocols to ensure patient safety in this context.

Figures

Figure 1. Flowchart of the study selection…
Figure 1. Flowchart of the study selection in this scoping review
Figure 3. Duration of PP among patients…
Figure 3. Duration of PP among patients with severe acute respiratory failure caused by COVID-19
Figure 4. Complications accruing from the use…
Figure 4. Complications accruing from the use of PP among patients with severe acute respiratory failure caused by COVID-19
Figure 5. Main outcomes from the use…
Figure 5. Main outcomes from the use of PP among patients with severe acute respiratory failure caused by COVID-19

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