Effect of prone position on respiratory mechanics and gas exchanges in patients
            with severe ARDS

Ananias, Maria Aparecida Nunes Bezerra; Cambraia, Amanda Alvarenga; Calderaro, Débora Cerqueira

doi:10.5935/2238-3182.20180140

Cited by 4 publications

(5 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This maneuver explores gravity and repositioning of the heart in the chest to recruit pulmonary perfusion ratio and arterial oxygenation (44) .…”

Section: A8 A9 A10 A11) the American Association Of Critical-mentioning

confidence: 99%

“…The prone position enables a redistribution of alveolar ventilation and perfusion. With a decrease in the effects of compression that favor atelectasis, pleural pressure is reduced, as well as transpulmonary pressures, and thus, alveolar recruitment can be achieved in atelectatic areas (44) . These PP mechanisms clarify the outcomes reported by the studies in the sample.…”

Section: A8 A9 A10 A11) the American Association Of Critical-mentioning

confidence: 99%

See 1 more Smart Citation

Prone positioning as an emerging tool in the care provided to patients infected with COVID-19: a scoping review

Araújo

Santos

Silva

et al. 2021

Rev. Latino-Am. Enfermagem

View full text Add to dashboard Cite

Objective: to describe scientific evidence regarding the use of prone positioning in the care provided to patients with acute respiratory failure caused by COVID-19. Method: this is a scoping review. PRISMA Extension for Scoping Reviews was used to support the writing of this study. The search was conducted in seven databases and resulted in 2,441 studies, 12 of which compose the sample. Descriptive statistics, such as relative and absolute frequencies, was used to analyze data. Results: prone positioning was mainly adopted in Intensive Care Units, lasted from a minimum of 12 up to 16 hours, and its prescription was based on specific criteria, such as PaO2/FiO2 ratio, oxygen saturation, and respiratory rate. The most prevalent complications were: accidental extubation, pressure ulcer, and facial edema. Decreased hypoxemia and mortality rates were the main outcomes reported. Conclusion: positive outcomes outweighed complications. Various cycles of prone positioning are needed, which may cause potential work overload for the health staff. Therefore, an appropriate number of trained workers is necessary, in addition to specific institutional protocols to ensure patient safety in this context.

show abstract

“…This maneuver explores gravity and repositioning of the heart in the chest to recruit pulmonary perfusion ratio and arterial oxygenation (44) .…”

Section: A8 A9 A10 A11) the American Association Of Critical-mentioning

confidence: 99%

Section: A8 A9 A10 A11) the American Association Of Critical-mentioning

confidence: 99%

Prone positioning as an emerging tool in the care provided to patients infected with COVID-19: a scoping review

Araújo

Santos

Silva

et al. 2021

Rev. Latino-Am. Enfermagem

View full text Add to dashboard Cite

show abstract

“…To improve oxygenation or ventilation, the prone or prone position is indicated in ARDS. In favor of gravity, there is a repositioning of the heart in the thorax for recruitment of pulmonary alveoli, in which a gravitational gradient of pleural pressure is reduced, transpulmonary pressures are more uniform and alveolar recruitment can be achieved in atelectatic regions, improving the ventilation ratio /perfusion, arterial oxygenation, and mortality of this non-COVID-19 syndrome (ANANIAS, CAMBRAIA, CALDERARO, 2017;CASTELL et al, 2016;COPPO et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

A Review of the Prone Position in Acute Respiratory Failure Due to Covid-19

Rodrigues¹

2023

JHS

View full text Add to dashboard Cite

To improve oxygenation, the prone position is indicated in acute respiratory distress syndrome, being used in critically ill patients. The use of prone position improves the hypoxemic level and reduces mortality when used early. The objective is to identify the indication and main benefits and complications of the prone position in patients admitted to the Intensive Care Unit under mechanical ventilation due to acute respiratory failure due to Covid-19. This is a narrative review of the literature carried out in August 2022, in the Scielo, PubMed and ``Portal de Periódicos Capes`` databases on the clinical indication, benefits and complications of the prone position in patients under mechanical ventilation due to acute respiratory failure due to Covid-19. 19, admitted to the Intensive Care Unit. The Health Sciences descriptors used were "Intensive Care Unit", "Covid-19" and "Prone" (prone position), using the Boolean operator "AND". The original publications were established as inclusion criteria, available in full in Portuguese, English and Spanish, published from 2020 to 2022. As it is a literature review, the study did not require approval from the ethics committee. They resulted in 14 scientific articles, eight from Capes and six from PubMed. Benefits were reported by seven articles, complications by two, and five dealt with the two themes (benefits and complications). Although this review did not make it possible to define the indications for the use of the prone position, some benefits pointed out were the improvement in the PaO2/FiO2 ratio, oxygenation, reduction in length of stay and mortality, and better lung compliance. With regard to complications, pressure injuries and accidental removal of medical devices such as an endotracheal tube and peripheral and central venous accesses occur. Finally, prone positioning was used in intubated and nonintubated patients, with significant PaO2/ FiO2 improvements in prone patients during the Covid-19 pandemic. The limitation in this review is that there is heterogeneity in the studies regarding the pronation criteria, its definition, use, benefits and complications, with cohort methods, cross-sectional studies and with casuistic interventions. Although the pandemic has already ended, retrospective studies are suggested to better investigate the conduct of pronation in patients with Covid-19 in intensive care.

show abstract

“…Assim, a PP pode contribuir na melhora da troca gasosa em regiões pulmonares pouco ou não aeradas situadas especialmente nas posições pulmonares gravidade-dependentes que, durante a PP, passariam a ser aeradas. Portanto, a posição prona atua como uma manobra de recrutamento com efeitos a longo prazo, que consequentemente, leva à melhora da oxigenação (Ananias, Cambraia, & Calderaro, 2017).…”

Section: Introductionunclassified

A Posição Prona e seus benefícios no tratamento da Síndrome do Desconforto Respiratório Agudo: uma revisão integrativa

Pereira¹,

Isidório²,

Souza³

et al. 2022

J. Educ. Sci and Health

View full text Add to dashboard Cite

Devido à alta mortalidade, estratégias terapêuticas alternativas têm sido adotadas na prática clínica da síndrome do desconforto respiratório agudo (SDRA), à exemplo da posição prona, que, com o paciente em decúbito ventral, alivia atelectasias e melhora oxigenação e perfusão. Objetivo: Verificar, na literatura, evidências que comprovem os benefícios do uso da posição prona em pacientes com síndrome do desconforto respiratório agudo (SDRA). Método. Revisão integrativa da literatura. Pesquisa nas bases de dados: BVS, SciELO, Lilacs, PubMed e Google Acadêmico, utilizando os Descritores em Ciências da Saúde (DeCS): Síndrome do Desconforto Respiratório do Adulto; Decúbito Ventral; Ventilação Mecânica; Ventilação não Invasiva; Fisioterapia, cruzados pelo operador booleano AND. Após aplicação dos critérios de elegibilidade e avaliação por títulos, resumos e leitura na íntegra, foram selecionados 13 estudos para a elaboração desta revisão. Resultados e Discussão. A posição prona (PP) é indispensável para redução da gravidade e da mortalidade da SDRA. Além de evitar a intubação orotraqueal, a PP promove melhora na relação PaO2/FiO2, aumento da saturação de O2, melhora da complacência pulmonar, redução no tempo de ocupação de leito de UTI e no tempo para alta hospitalar. A PP é uma técnica de baixo custo altamente eficiente com vários benefícios à mecânica respiratória dos pacientes.

show abstract

Effect of prone position on respiratory mechanics and gas exchanges in patients with severe ARDS

Cited by 4 publications

References 7 publications

Prone positioning as an emerging tool in the care provided to patients infected with COVID-19: a scoping review

Prone positioning as an emerging tool in the care provided to patients infected with COVID-19: a scoping review

A Review of the Prone Position in Acute Respiratory Failure Due to Covid-19

A Posição Prona e seus benefícios no tratamento da Síndrome do Desconforto Respiratório Agudo: uma revisão integrativa

Contact Info

Product

Resources

About