COVID-19 disease: Acute respiratory distress syndrome and prone position

Reece-Anthony, R.; Lao, Grace; Carter, Chris; Notter, Joy

doi:10.1016/j.intcar.2020.100024

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…Desde 1970, a estratégia de ventilação em posição prona com VMI tem sido praticada em pacientes com atelectasia e diminuição da complacência pulmonar. Essa técnica permite o recrutamento das zonas posterobasais pulmonares, melhorando a oxigenação pulmonar ( 2 , 8 , 9 ) e a relação ventilação/perfusão desses segmentos pulmonares. ( 4 , 6 , 10 - 12 ) A posição prona é uma das poucas estratégias que demonstraram reduzir a mortalidade na SDRA.…”

Section: Introductionunclassified

“…(4)(5)(6)(7) The prone ventilation strategy with IMV has been practiced since 1970 in patients with atelectasis and decreased lung compliance. This technique allows for the recruitment of the pulmonary posterobasal zones, thus improving pulmonary oxygenation (2,8,9) and the ventilation/ perfusion ratio of these lung segments. (4,6,(10)(11)(12) The prone position is one of the few strategies shown to decrease mortality in ARDS.…”

Section: Introductionmentioning

confidence: 99%

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Conscious prone positioning in nonintubated COVID-19 patients with acute respiratory distress syndrome: systematic review and meta-analysis

Vásquez-Tirado,

Meregildo-Rodríguez,

Asmat-Rubio

et al. 2024

Crit. Care Sci.

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Objective: To systematically review the effect of the prone position on endotracheal intubation and mortality in nonintubated COVID-19 patients with acute respiratory distress syndrome. Methods: We registered the protocol (CRD42021286711) and searched for four databases and gray literature from inception to December 31, 2022. We included observational studies and clinical trials. There was no limit by date or the language of publication. We excluded case reports, case series, studies not available in full text, and those studies that included children < 18-years-old. Results: We included ten observational studies, eight clinical trials, 3,969 patients, 1,120 endotracheal intubation events, and 843 deaths. All of the studies had a low risk of bias (Newcastle-Ottawa Scale and Risk of Bias 2 tools). We found that the conscious prone position decreased the odds of endotracheal intubation by 44% (OR 0.56; 95%CI 0.40 - 0.78) and mortality by 43% (OR 0.57; 95%CI 0.39 - 0.84) in nonintubated COVID-19 patients with acute respiratory distress syndrome. This protective effect on endotracheal intubation and mortality was more robust in those who spent > 8 hours/day in the conscious prone position (OR 0.43; 95%CI 0.26 - 0.72 and OR 0.38; 95%CI 0.24 - 0.60, respectively). The certainty of the evidence according to the GRADE criteria was moderate. Conclusion: The conscious prone position decreased the odds of endotracheal intubation and mortality, especially when patients spent over 8 hours/day in the conscious prone position and treatment in the intensive care unit. However, our results should be cautiously interpreted due to limitations in evaluating randomized clinical trials, nonrandomized clinical trials and observational studies. However, despite systematic reviews with meta-analyses of randomized clinical trials, we must keep in mind that these studies remain heterogeneous from a clinical and methodological point of view.

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Section: Introductionunclassified

Section: Introductionmentioning

confidence: 99%

Conscious prone positioning in nonintubated COVID-19 patients with acute respiratory distress syndrome: systematic review and meta-analysis

Vásquez-Tirado,

Meregildo-Rodríguez,

Asmat-Rubio

et al. 2024

Crit. Care Sci.

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“…Used in surgical procedures from ancient times to the present day, prone positioning allows better visualization and access to the particular location of the therapy, as in head, neck, and spine surgeries (2) . In addition to surgical procedures, it has been observed in recent years that the prone position in patients with Acute Respiratory Distress Syndrome (ARDS) can improve oxygenation and reduce mortality (3)(4) .…”

Section: Introductionmentioning

confidence: 99%

Eye Care Interventions in Critical/Surgical Patients in the Prone Position: Scoping Review

et al. 2022

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Objectives: This study aimed to map evidence of eye care interventions in managing critical or surgical patients submitted to prone positions. Materials and method: This scoping review was prepared according to the Joanna Briggs Institute’s methodology, following the PRISMA-ScR criteria. A search was conducted from July to August 2020 in the SCOPUS, Web of Science, Science Direct, PubMed Central, CINAHL, and COCHRANE databases. The following research question was delimited: “What are the strategies and interventions used for eye care in the management of critical patients or surgical patients submitted to the prone position?” The sample consisted of 24 studies after applying the inclusion and exclusion criteria. Results: Eye care interventions in managing critical/surgical patients submitted to the prone position were eye examination, use of lubricants/specific ophthalmic solution, reverse Trendelenburg positioning, and protection with adhesive tape. Conclusions: This review allowed the understanding of eye care for critical/surgical patients in a prone position. Among the care presented, a large part is related to nursing since it is closer to patient care. The findings emphasize the need to implement patient safety policies with eye care as a priority.

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Neurological Consequences of Pulmonary Emboli in COVID-19 Patients: A Study of Incidence and Outcomes in the Kingdom of Saudi Arabia

et al. 2023

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Pulmonary embolism (PE) is a significant consequence that is becoming more common in COVID-19 patients. The current study sought to determine the prevalence and risk factors for PE in a study population of COVID-19 patients, as well as the relationship between PE and neurological sequelae. The research also sought to analyze the consistency of neurological examination and imaging techniques in detecting neurological problems. The research comprised a total of 63 individuals with COVID-19. The incidence of PE in the study group was 9.5% for smokers, 23.8% for obese patients, 33.3% for hypertensive patients, and 19% for diabetic patients, according to the findings. After adjusting for possible confounders such as age, gender, BMI, smoking, hypertension, and diabetes, a logistic regression analysis indicated that the probabilities of having neurological complications were 3.5 times greater in individuals who had PE. In conclusion, the present study highlights the high incidence of PE among patients with COVID-19 and the association between PE and neurological complications. The study also emphasizes the importance of a thorough neurological examination and imaging studies in the detection of neurological complications in patients with PE.

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COVID-19 disease: Acute respiratory distress syndrome and prone position

Cited by 5 publications

References 29 publications

Conscious prone positioning in nonintubated COVID-19 patients with acute respiratory distress syndrome: systematic review and meta-analysis

Conscious prone positioning in nonintubated COVID-19 patients with acute respiratory distress syndrome: systematic review and meta-analysis

Eye Care Interventions in Critical/Surgical Patients in the Prone Position: Scoping Review

Neurological Consequences of Pulmonary Emboli in COVID-19 Patients: A Study of Incidence and Outcomes in the Kingdom of Saudi Arabia

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