Examining Historical Data to Inform Future Preparedness: Systematic Review of the Effects of Prone Positioning on Oxygen Levels in Nonintubated COVID-19 Patients

Abstract

Over time, there has been a significant increase in the utilization of prone positioning (PP) as a strategy to improve oxygen levels in patients requiring mechanical ventilation for the management of acute respiratory distress syndrome. PP has emerged as a potential intervention for enhancing oxygenation in nonintubated patients with COVID-19. The current systematic review aims to assess existing evidence regarding the impact of PP on oxygen parameters in this patient population. Understanding the effectiveness and possible advantages of PP in optimizing oxygenation could contribute to enhanced management strategies for COVID-19 cases, particularly those that do not require invasive mechanical ventilation. Comprehensive search was conducted using electronic databases to identify the relevant studies, covering the period of 2019–2023. A two-part tool was employed to address five specific domains alongside other potential biases. Quality assessment of diagnostic accuracy studies was undertaken using a risk of bias. In a present systematic review, 15 studies were included. The findings suggest that PP had a notable influence on oxygen parameters. The PP was a beneficial intervention for nonintubated patients of COVID-19 in terms of improving oxygen parameters. The evidence suggests that PP can contribute to enhanced oxygenation in patients. Further research is necessary for a better understanding of optimal techniques, patient selection criteria, and long-term outcomes linked with PP.

Keywords

• awake proning
• covid-19
• nonintubated
• prone positioning
• respiratory distress