BENEFITS OF PRONE POSITION COMPARED WITH DORSAL POSITION IN ADULTS/ ELDERLY PATIENTS WITH COVID-19 AND IN INVASIVE MECHANICAL VENTILATION INTERNED IN INTENSIVE MEDICINE SERVICES: A SCOPING REVIEW (Atena Editora)

Abstract

Prone Position (PP) is widely used in patients diagnosed with Acute Respiratory Distress Syndrome (ARDS), positive for COVID-19, under Invasive Mechanical Ventilation, in order to improve oxygenation/ventilation and reduce mortality. This technique is quite used in Intensive Care Units in alternation with the Dorsal Position (DP). This Scoping Review aims to analyze parameters such as: PaO2 /FiO2 ratio, pulmonary compliance, atelectasis/dead space, ARDS severity, PP time and mortality rate, in both positions, in order to verify the benefits of PP relatively to DP existing in the literature. Data collection was performed in the following databases: PubMed, Scopus, Web of Science and Google Scholar. The eligibility criteria were defined as: articles published between 2020 and 2022, with full text and in Portuguese and English, resulting in a total of seven articles. There were no significant differences in the following parameters: lung compliance, atelectasis/ dead spaces, ARDS severity and mortality rate. As for the time of PP, it was found that there was unanimity (average of 16 hours per day); and that the PaO2 /FiO2 ratio, for the most part, improved during PP compared to DP, which allows for an improvement in the efficiency of oxygenation/ventilation. Thus, it is possible to conclude that the increase in the PaO2 /FiO2 ratio is the indicator in which the best benefits are observed. It is suggested that other studies be carried out, with specific criteria, so that other more concrete evidence can be described.