Evaluating Prone Cardiopulmonary Resuscitation Techniques in the Surgical Settings: A Systematic Review of Case Studies.

Purpose: Examine the prone cardiopulmonary resuscitation techniques in patients undergoing surgery.

Design: Systematic review.

Methods: Using the preferred reporting items for systematic reviews and meta-analysis guidelines, PubMed, CINAHL, Cochrane Library, Google Scholar, and gray literature databases were searched to obtain eligible studies. The methodological quality of the case studies was assessed using the tool proposed by Murad and colleagues. Case reports involving surgical patients in a prone position were included.

Findings: A total of 21 patients undergoing neurologic or spinal surgeries were evaluated. The most common cardiac rhythms observed before arrest were pulseless electrical activity, asystole, ventricular tachycardia, ventricular fibrillation, and sudden bradycardia. The etiologies of the cardiac arrests included venous air embolism, hemorrhagic shock, and hypovolemia. Posterior compressions at T7 to T9 vertebral segment, with or without counterpressure, were immediately instituted. Return of spontaneous circulation was achieved in each instance, with an average time to return of spontaneous circulation of 5.60 minutes. Using a quality assessment tool, we determined that all case reports were of high quality and exhibited a low risk of bias.

Conclusions: Prone resuscitation during neurosurgical or spinal surgeries has demonstrated promising outcomes. Additionally, the findings of this review further emphasize the need to train health care personnel in the techniques of prone cardiopulmonary resuscitation.