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CuidArte ”El Arte del Cuidado”

2022, Number 21

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CuidArte 2022; 11 (21)

“Prone vs. supine position in alveolar recruitment of mechanically ventilated patients and covid-19

Pool VRK, Aguilar QCM, del Socorro PKEB, Gil CJA

Language: Spanish
References: 30
Page: 40-51
PDF size: 259.94 Kb.


ABSTRACT

Introduction. Faced with the worldwide spread of COVID-19 disease, best practices for mechanical ventilation in some patients are debated, specifically high positive end-expiratory pressure (PEEP) and prone position, the prone position is a simple method to improve oxygenation in ventilated patients with ARDS secondary to COVID-19, due to the marked improvement in ventilation-perfusion (V/Q), considering the better-perfused areas, an increase in aerated lung volume. Objective. To compare the efficacy of prone versus supine position to improve alveolar recruitment in adults with COVID-19 on mechanical ventilation. Methodology. Systematic review. Databases consulted: Cochrane library, EBN, PubMed, Elsevier, and Epistemonikos. For the execution of the search the Boléan descriptors were AND and OR, this was carried out in two periods. For the quick selection, the titles and abstracts were used as bases, following the eligibility criteria, including 11 articles. Results. The studies analyzed demonstrated efficacy in alveolar recruitment improving oxygenation and pulmonary distensibility with a median of two sessions; another study demonstrated that early prone positioning was feasible and effective in improving oxygenation in COVID-19 patients on mechanical ventilation. Conclusions. Based on the findings, it was demonstrated that prone positioning favors alveolar recruitment. An area of opportunity was found to investigate whether there are better results in the management of the COVID-19 patient in a prone position with mechanical ventilation or in patients who do not require it.


REFERENCES

  1. McNicholas B, Cosgrave D, Giacomini C, Brennan A, Laffey JG. Prone positioning in COVID-19 acute respiratory failure: just do it? Br J Anaesth. [Internet] 2020; 125 (4): 440–443. DOI: https://doi.org/10.1016/j.bja.2020.06.003

  2. Eliecer P, Camilo J, Otilio L, Sharon W, Ximena V. Ventilatory support in SARS-VOC-2 during intensive therapy. medRxiv. [Internet] 2020. DOI: https://dx.doi.org/10.1101/2020.05.14.20098608

  3. Gallardo A. Posición prono y bloqueantes neuromusculares como parte del cuidado estándar en pacientes con SDRA severo. Revista Americana de Medicina Respiratoria [Internet] 2016; 16 (1): 94–98. Disponible en: https://bit. ly/3cKgYOB

  4. Carrillo-Esper R, Mejía-Gómez L, Monares-Zepeda E, Chavarría-Martínez U, Díaz-Carrillo A, Ayala-León M, et al. Abordaje hemodinámico y ventilatorio en pacientes con COVID-19. Cir y Cir [Internet] 2020; 88 (6): 805–817. DOI: https://doi.org/10.24875/CIRU.20000301

  5. Comité Nacional para la Vigilancia Epidemiológica [Internet]. Aviso Epidemiológico. Aviso epidemiológico. Estados Unidos Mexicanos; 2020. Disponible en: https://bit.ly/3It5IF7

  6. Organización Panamericana de la Salud. La OMS declara que el nuevo brote de coronavirus es una emergencia de salud pública de importancia internacional [Internet]. La OMS declara que el nuevo brote de coronavirus es una emergencia de salud pública de importancia internacional; 2020. Disponible en: https://bit.ly/3l5NoYG

  7. Secretaría de Salud de Yucatán. Comunicado de prensa de la secretaría de salud de Yucatán [Internet]. Comunicado de prensa de la Secretaría de Salud de Yucatán; 2021. Disponible en: https://bit.ly/3oU3tlk

  8. Suárez V, Quezada M, Ruiz S, Ronquillo De Jesús E. Epidemiología de COVID-19 en México: del 27 de febrero al 30 de abril de 2020. Revista Clínica Española [Internet] 2020; 220 (8). DOI: https://doi.org/10.1016/j.rce.2020.05.007

  9. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et. al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet [Internet] 2020; 395 (10229): 1054–1062. DOI: https://doi.org/10.1016/S0140-6736(20)30566-3

  10. Taboada M, Bermúdez A, Pérez M, Campaña O. Supine versus prone positioning in COVID-19 pneumonia: Comment. Anesthesiology [Internet] 2020; 135 (5): 1155–1157. DOI: https://doi.org/10.1097/ALN.0000000000003511

  11. Bloomfield R, Noble DW, Sudlow A. Prone position for acute respiratory failure in adults. Cochrane Database of Systematic Reviews [Internet] 2015; (11-CD008095). DOI: https://doi.org/10.1002/14651858.CD008095.pub2

  12. Setten M, Plotnikow GA, Accoce M. Prone position in patients with acute respiratory distress syndrome. Revista Brasileira de Terapia Intensiva [Internet] 2016; 28 (4): 452–462. DOI: https://doi.org/10.5935/0103-507X.20160066

  13. González-Castro A, Escudero-Acha P, Arnaiz F, Ferrer D. Oxigenoterapia de alto flujo y posición de prono con respiración espontánea en neumonía por SARS-CoV-2. Soc Española Anestesiol [Internet] 2020; 67 (9): 529–530. DOI: https://doi.org/10.1016/j.redar.2020.05.014

  14. Sepúlveda P, Porras M. Guía prono vigil usuarios con insuficiencia respiratoria aguda en contexto de pandemia COVID-19. Soc Chil Med Intensiva: Chile; 2020. Disponible en: https://www.medicina-intensiva.cl/site/covid/guias/ Guia_prono_vigil.pdf

  15. Gordo F, Hermosa C. Fisiología y evidencia se unen en favor de la posición de decúbito prono. Medicina Intensiva [Internet] 2015; 39 (6): 327–328. DOI: https://doi.org/10.1016/j.medin.2015.03.006

  16. Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Medicine [internet] 2020; 46: 854–887. DOI: https://doi.org/10.1007/s00134-020-06022-5

  17. Chacko B, Peter JV, Tharyan P, John G, Jeyaseelan L. Pressure-controlled versus volume-controlled ventilation for acute respiratory failure due to acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Cochrane Database Syst Rev [Internet] 2015; (1 - CD008807). DOI: https://doi.org/10.1002/14651858.CD008807.pub2

  18. Descriptores en Ciencias de la Salud: DeCS [Internet]. ed. 2017. Sao Paulo (SP): BIREME / OPS / OMS. 2017. Disponible en: https://bit.ly/3yRxWop

  19. US) NL of M. Medical Subject Headings (MeSH) [Internet]. 2002. Disponible en: https://bit.ly/2UhMTxt

  20. Fernandez LS, Anis K, Maltseva A. Repeated Pronation in a Morbidly Obese Patient Overcome By a Severe Covid-19 Infection. Chest [Internet]. 2020;158(4):A2575. Disponible en: https://doi.org/10.1016/j.chest.2020.09.171

  21. Mittermaier M, Pickerodt P, Kurth F, de Jarcy L, Uhrig A, García C, et al. Evaluation of PEEP and prone positioning in COVID-19 ARDS. EClinicalMedicine [Internet] 2020; 28. DOI: https://dx.doi.org/10.1016/j.eclinm.2020.100579

  22. Chica-Meza C, Peña-López LA, Villamarín-Guerrero HF, Moreno-Collazos JE, Rodríguez-Corredor LC, Lozano WM, et al. Cuidado respiratorio en COVID-19. Acta Colomb Cuid Intensivo [Internet] 2020; 20 (2): 108–117. DOI: https://doi. org/10.1016/j.acci.2020.04.001

  23. Freixes M, Garrido E, Roca A. El decúbito prono como estrategia terapéutica para la mejora del síndrome de distrés respiratorio agudo. Metas Enfer [Internet] 2017; 20 (1): 57–63. DOI: https://doi.org/10.35667/ metasenf.2019.20.1003081019

  24. Instituto de Efectividad Clínica y Sanitaria [Internet]. Posicionamiento en prono en infección por COVID-19; 2020. Disponible en: https://bit.ly/3srdrxR

  25. Ziehr DR, Alladina J, Petri CR, Maley JH, Moskowitz A, Medoff BD, et al. Respiratory pathophysiology of mechanically ventilated patients with COVID-19: A cohort study. Am J Respir Crit Care Med [Internet] 2020; 201 (12): 1560–1564. DOI: https://doi.org/10.1164/rccm.202004-1163LE

  26. Zarantonello F, Andreatta G, Sella N, Navalesi P. Prone position and lung ventilation and perfusion matching in acute respiratory failure due to COVID-19. Am J Respir Crit Care Med [Internet] 2020; 202 (2): 278–279. DOI: https://doi. org/10.1164/rccm.202003-0775IM

  27. Camargo Rubio, R. D. (2021). Principio de proporcionalidad terapéutica en la decisión de intubación orotraqueal y ventilación mecánica invasiva en paciente COVID-19 grave. Acta Colombiana de Cuidado Intensivo [Internet] DOI: https://doi.org/10.1016/j.acci.2020.12.003

  28. Mora-Arteaga JA, Bernal-Ramírez OJ, Rodríguez SJ. Efecto de la ventilación mecánica en posición prona en pacientes con síndrome de dificultad respiratoria aguda. Una revisión sistemática y metanálisis. Med Intensiva [Internet] 2015; 39 (6): 352–365. DOI: https://doi.org/10.1016/j.medin.2014.11.003

  29. Franco-Paredes C, Kuri-Morales P, Alvarez-Lucas C, Palacios-Zavala E, Nava-Frías M, Betancourt-Cravioto M, et al. Síndrome Agudo Respiratorio Severo: Un panorama mundial de la epidemia. Salud Pública de México [Internet] 2003; 45 (3): 211–220. DOI: https://doi.org/10.1590/s0036-36342003000300011

  30. Puig G, Giménez-Milà M, Campistol E, Caño V, Valcarcel J, Colomina MJ. Desarrollo de enfermedades concomitantes en pacientes críticos con COVID-19. Rev Esp Anestesiol Reanim [Internet] 2021; 68 (1): 37–40. DOI: https://doi. org/10.1016/j.redar.2020.09.001




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