THE EFFECTS OF PRONE POSITIONING IN MECHANICALLY VENTILATED PATIENTS WITH COVID-19 : A SYSTEMATIC REVIEW

Abstract

Background: The COVID-19 pandemic presented challenging times for everyone and impacted healthcare tremendously. Prone positioning (PP) was implemented to address inadequate oxygenation in mechanically ventilated patients with COVID19. Prone positioning, which involves placing a patient face down, improves gas exchange and oxygen perfusion. For this reason, PP was introduced as a treatment option for patients with hypoxemia secondary to COVID-19. Objective: The purpose of this systematic review was to analyze the effects of PP on mechanically ventilated patients with COVID-19. Methods: PubMed and EMBASE databases were searched using terms relating to PP, COVID-19, and mechanical ventilation. Researchers screened titles, abstracts, and full texts, removing any duplicates. The JBI Critical appraisal Tool was used to assess selected articles. Results: Six studies met inclusion criteria for the study, with a total of 421 participants. Primary outcomes assessed included oxygenation parameters. All included studies met the JBI Critical Appraisal criteria to be deemed acceptable for the systematic review. Conclusion: Physical therapists play an important role in mobility of patients in the ICU setting and may be involved in determining treatments to improve oxygenation in patients with COVID-19. Data consistently indicated that prone positioning may be an appropriate intervention to improve oxygenation in patients with respiratory failure due to COVID-19. Several articles indicated increased time in prone may lead to increase in improvements in oxygenation, but continued research is needed to determine the optimal time in prone. Due to the novelty of COVID-19, limited research participants, and low-level research study design, more studies on this topic are recommended.