Awake Prone-Positioning in Patients on Non-Invasive Ventilation for Management of SARS-CoV-2 Pneumonia: A Systematic Review
Abstract
Highlights Awake proning has an established role in both COVID and non-COVID acute hypoxemic respiratory failure (AHRF). Patients with COVID AHRF are often on NIV, and the use of awake prone positioning may pose concerns regarding feasibility, efficacy and side effects. This systematic review was undertaken to evaluate the feasibility and efficacy of awake proving along with NIV in NIV patients. Awake proning in NIV patients had a feasibility ranging from 36 to 100% and an increased efficacy in terms of improvement in oxygenation with no significant side effects. We observed a moderate-to-serious risk of bias amongst the included non-randomized observational studies and heterogeneity in terms of respiratory supports and/or the interface used by the patients. Abstract Introduction: Patients with corona virus disease-19 (COVID-19)-induced acute hypoxemic respiratory failure (AHRF) are often on non-invasive ventilation (NIV) and use of awake prone positioning (PP) may pose concern in terms of feasibility, efficacy and side effects. This systematic review was undertaken to evaluate the feasibility and efficacy of awake PP along with NIV in them. Materials and Methods: A systematic literature search was conducted from the inception of COVID-19 until 15 August 2021. Various factors including feasibility, interface used, outcome, efficacy, side effects and limitations in both intensive care unit (ICU) and Non-ICU setups were noted. Results: A total of 12 original articles and six…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 359 participants or records.
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