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 and 3 others
PMID 33439949WHAT IT FOUND
Prone positioning improved oxygenation and reduced mortality in patients with severe COVID-19 respiratory failure.
Nurses must monitor for accidental extubation, pressure injuries, and facial edema, which occurred in half to three-quarters of reported cases.
Key findings
01The most common complications associated with prone positioning were accidental extubation (78%), pressure ulcers (50%), and facial edema (50%).
02Improved oxygenation and decreased mortality were the primary outcomes identified across the included studies.
03Most studies recommended maintaining the prone position for 12 to 16 hours.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included no randomized controlled trials, relying mostly on expert consensus, reviews, and case studies. The search was limited to studies published only a few months into the pandemic (December 2019 to May 2020). The evidence is heterogeneous, with varying definitions of success and complication rates across the 12 included studies.
Declared interests
The authors declare no conflicts of interest or specific funding sources for this review.
The easy way to misread this
Do not assume prone positioning is safe simply because it improves oxygenation. The review found accidental extubation in 78% of studies reporting complications, requiring vigilant airway management. Additionally, the evidence base is low certainty, consisting mostly of expert opinion and case reports rather than robust trials.