Keywords
Prone position
Respiratory failure
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Abstract
Objective: To evaluate the effectiveness of the prone position in patients with COVID-19, conscious or sedated, admitted to Intensive Care Units (ICU) during the pandemic, highlighting the results in the management of respiratory failure. Methods: This is an integrative review of the last five years in databases such as PubMed and the Google Scholar search engine, regarding the use of the prone position in patients with COVID-19 on mechanical ventilation. Results: The reviewed articles highlight that the prone position was highly effective, improving oxygen saturation, O2 supply and demand, as well as reducing the need for mechanical ventilation and also death outcomes. However, despite the great benefits, the occurrence of pressure injuries requires training and good nursing interventions to reduce cases of PPI. Final considerations: The use of the prone position has become an important strategy in the treatment of respiratory failure in patients with COVID-19.
References
AHMAD AF, et al. Saberes e práticas da enfermagem no manejo do paciente em posição prona: estudo descritivo / Nursing knowledge and practices regarding placing patients in the prone position: a descriptive study / Conocimientos y prácticas de enfermería en la gestión del paciente en posición prona: estudio descriptivo. Online braz. j. nurs. (Online). 2021; 20210056.
ALTHUNAYYAN S, et al. Prone position protocol in awake COVID-19 patients: A prospective study in the emergency department. J Infect Public Health. 2022; 15(4): 480-485.
BARJA E, et al. Prone positioning in COVID-19 patients with acute respiratory distress syndrome and invasive mechanical ventilation. Enferm Intensiva (Engl Ed). 2023; 34(2): 70-79.
BATALHA JC, et al. Musicoterapia e seus efeitos no ambiente hospitalar. Research, Society and Development, 2022; 11(6): 12411626747.
BITENCOURT GR, et al. Pronação do Idoso na Covid-19: Considerações de Enfermagem Gerontológica. In: Santana RF (Org.). Enfermagem gerontológica no cuidado do idoso em tempos da COVID 19. Brasilia, DF: Editora Aben (Serie Enfermagem e Pandemias, 5), 2021; 171.
CAMPOROTA L, et al. Prone Position in COVID-19 and -COVID-19 acute respiratory distress syndrome: An International Multicenter Observational Comparative Study. Crit Care Med. 2022; 50(4): 633-643.
CHUA EX, et al. Effect of prone versus supine position in COVID-19 patients: A systematic review and meta-analysis. J Clin Anesth. 2021; 74: 110406.
CONCEIÇÃO DB, et al. COVID-19 e prona: prevenção de lesão por pressão pela enfermagem. Revista Recien - Revista Científica de Enfermagem, 2021; 11(36): 112–118.
CUNHA MC, et al. Impact of prone positioning on patients with COVID-19 and ARDS on invasive mechanical ventilation: a multicenter cohort study. J Bras Pneumol. 2022; 48(2): 20210374.
FOSSALI T, et al. Effects of Prone Position on Lung Recruitment and Ventilation-Perfusion Matching in Patients With COVID-19 Acute Respiratory Distress Syndrome: A Combined CT Scan/Electrical Impedance Tomography Study. Crit Care Med. 2022; 50(5): 723-732.
GRASSELLI G, et al. Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy [published correction appears in JAMA Intern Med. 2021; 181(7): 1021. JAMA Intern Med. 2020;180(10): 1345-1355.
LANGER T, et al. Prone position in intubated, mechanically ventilated patients with COVID-19: a multi-centric study of more than 1000 patients. Crit Care. 2021; 25(1): 128.
LIMA GR, et al. Nursing care to COVID-19 patients on hemodialysis and in prone position: an experience report. Rev Esc Enferm USP.
NAY MA, et al. Prone position versus usual care in hypoxemic COVID-19 patients in medical wards: a randomised controlled trial. Crit Care. 2023; 27(1): 240.
OKIN D, et al. Prolonged Prone Position Ventilation Is Associated With Reduced Mortality in Intubated COVID-19 Patients. Chest. 2023; 163(3): 533-542.
OMS. ORGANIZAÇÃO MUNDIAL DA SAÚDE. Histórico da pandemia de COVID-19. Brasília. Acesso em: 27/03/2024.
QIN S, et al. Awake prone position in COVID-19-related acute respiratory failure: a meta-analysis of randomized controlled trials. BMC Pulm Med. 2023; 23(1): 145.
RIGHI, NC. et al. Perception of health professionals on the prone position as a therapeutic strategy for patients with COVID-19. Fisioterapia e Pesquisa, 2022; 29(2): 176–180.
RODRÍGUEZ MD, et al. Nursing care and prevalence of adverse events in prone position: Characteristics of mechanically ventilated patients with severe SARS-CoV-2 pulmonary infection. Nurs Crit Care. 2022; 27(4): 493-500.
ROLLINSON TC, et al. Neuromuscular blockade and oxygenation changes during prone positioning in COVID-19. J Crit Care.
SANTOS PS, et al. Perfil epidemiológico da mortalidade de pacientes internados por Covid-19 na unidade de terapia intensiva de um hospital universitário / Epidemiological profile of mortality of patients hospitalized for Covid-19 in the intensive care unit of a university hospital. Brazilian Journal of Development, 7(5); 45981–45992.
SILVA VG, et al. Trabalho do enfermeiro no contexto da pandemia de COVID-19. Rev Bras Enferm. 2021; 74(1): 20200594.
SOCIEDADE BRASILEIRA DE INFECTOLOGIA. Situação no Brasil. São Paulo. Disponível em: < https ://infectologia.org.br/pandemia-covid-19/situacao-no-brasil/>. Acesso em: 27/03/2024.
TAKMAK S, et al. The effect of nature-based music intervention on adaptation and anxiety levels in patients with COVID-19 placed in the prone position: A randomized controlled trial. Intensive Crit Care Nurs. 2023; 79: 103496.
WALTER T, et al. Extended prone positioning duration for COVID-19-related ARDS: benefits and detriments. Crit Care. 2022; 26(1): 208.
ZANCHETTA FC, et al. Incidência de lesão por pressão em posição prona durante a pandemia de COVID-19: um estudo de coorte / Incidence of prone position pressure sores during the COVID-19 pandemic: a cohort study / Incidencia de lesión por presión en decúbito prono durante la pandemia de COVID-19: un estudio de cohorte. Online braz. j. nurs. (Online); 2022; 21(2): 20226569.
ZIEHR DR, et al. Respiratory pathophysiology of mechanically ventilated patients with COVID-19: a cohort study. Am J Respir Crit Care Med. 2020; 201: 1560–1564.
ZIQIN NG, et al. Awake Prone Positioning for Non-intubated Oxygen Dependent COVID-19 Pneumonia Patients. European Respiratory Journal [Internet] Eu. Respir. Soc. (ERS) 2020; 56(1).