Prone position during mechanical ventilation in critically ill patients

Added March 25, 2020

Citation: Bloomfield R, Noble DW, Sudlow A. Prone position for acute respiratory failure in adults. Cochrane Database of Systematic Reviews 2015; (11): CD008095

What is this? Some patients with COVID-19 will become critically ill and develop acute respiratory distress syndrome (ARDS). They may require mechanical ventilation (MV) in an intensive care unit (ICU). They might be placed in the prone position for this, rather than in a supine or recumbent position.

In this Cochrane systematic review, the authors searched for randomized trials of the effects of using a prone position rather than a supine or semi-recumbent position during conventional MV for adults with acute respiratory failure. They did not restrict by language of publication and did their most recent searches in June 2015. They included 9 studies (2165 participants), and identified a further 5 studies that are awaiting classification in a future update of the review.

What works: The studies suggest that patients for whom early implementation of prone positioning or prolonged adoption of prone positioning are used, or who have severe hypoxaemia, are less likely to die.

What doesn’t work: Nothing noted.

What’s uncertain: The groups of patients for whom prone positioning is not beneficial is uncertain.

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.

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