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俯卧位作为一种新兴的治疗工具,应用于 COVID-19 感染患者的护理中:系统评价。

Prone positioning as an emerging tool in the care provided to patients infected with COVID-19: a scoping review.

机构信息

Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.

出版信息

Rev Lat Am Enfermagem. 2021 Jan 8;29:e3397. doi: 10.1590/1518-8345.4732.3397. eCollection 2021.

Abstract

OBJECTIVE

to describe scientific evidence regarding the use of prone positioning in the care provided to patients with acute respiratory failure caused by COVID-19.

METHOD

this is a scoping review. PRISMA Extension for Scoping Reviews was used to support the writing of this study. The search was conducted in seven databases and resulted in 2,441 studies, 12 of which compose the sample. Descriptive statistics, such as relative and absolute frequencies, was used to analyze data.

RESULTS

prone positioning was mainly adopted in Intensive Care Units, lasted from a minimum of 12 up to 16 hours, and its prescription was based on specific criteria, such as PaO2/FiO2 ratio, oxygen saturation, and respiratory rate. The most prevalent complications were: accidental extubation, pressure ulcer, and facial edema. Decreased hypoxemia and mortality rates were the main outcomes reported.

CONCLUSION

positive outcomes outweighed complications. Various cycles of prone positioning are needed, which may cause potential work overload for the health staff. Therefore, an appropriate number of trained workers is necessary, in addition to specific institutional protocols to ensure patient safety in this context.

摘要

目的

描述 COVID-19 引起的急性呼吸衰竭患者护理中采用俯卧位的科学证据。

方法

这是一个范围综述。PRISMA 扩展用于支持本研究的写作。检索在七个数据库中进行,共产生了 2441 项研究,其中 12 项构成了样本。使用描述性统计,如相对频率和绝对频率,来分析数据。

结果

俯卧位主要在重症监护病房采用,持续时间从最短的 12 小时到最长的 16 小时不等,其处方是基于特定的标准,如 PaO2/FiO2 比值、氧饱和度和呼吸率。最常见的并发症是:意外拔管、压疮和面部水肿。报告的主要结果是低氧血症和死亡率降低。

结论

积极的结果超过了并发症。需要进行多个周期的俯卧位治疗,这可能会给卫生人员带来潜在的工作负担。因此,除了特定的机构协议外,还需要有适当数量的经过培训的工作人员,以确保在这种情况下患者的安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8686/7798394/9417c9544d1c/0104-1169-rlae-29-e3397-gf01.jpg

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