Utility of the awake prone position in COVID-19.

Abstract

Abstract

Introduction: Respiratory failure secondary to the acute respiratory distress syndrome (ARDS) from COVID-19 is the most relevant and deadly pathologic process of this sickness. Among the support measurements to complement the treatment of COVID-19-associated ARDS (CARDS), the prone position (PP) and its potential benefit in conscious patients is a relevant consideration.

Objective: To do a theory review of the evidence which sustains the applicability of the prone position as a potential strategy in the benefit of conscious patients with respiratory insufficiency due to COVID-19.

Methodology: An advanced research was performed in the databases of Pubmed and Google Scholar. The terms used were: “SARS-CoV-2 infection”; “COVID-19”; “Acute respiratory distress syndrome”; “Awake o non intubated”; “Prone position” or “Prone positioning” these were operated with Boolean terms “AND” and “OR” 33 articles were gathered fulfilling inclusion criteria.

Results and Conclusions: Among the therapeutic support measurements in conscious patients with CARDS from mild to moderate, the evidence suggests the positioning in DP seems safe, it can decrease the effort and postpone respiratory deterioration. Besides improving oxygenation by postponing, differing, and even dispensing with the mechanical ventilation need in selected cases, especially, if it is associated with a no invasive ventilation (NIV) and high flow nasal cannule (HFNC); which could reduce the pressure in the emergency services, and intensive cares, although its real impact over the clinic results, mortality, and rate intubations are not established yet.