Posisi Pronasi terhadap Oksigenasi Pasien COVID-19 dengan Terapi Oksigen Non-Invasif
Abstract
This study aims to identify evidence on the effect of pronation position on oxygenation in conscious COVID-19 patients receiving non-invasive oxygen therapy. This research method is systematic review research. Literature searches from 2020-2021 were carried out in the online databases of Science Direct, ProQuest, EBSCOhost, and PubMed. The results showed that the majority of the samples were male (69.7%) with an average age of over 50 years and a body mass index (BMI) above average (>23,9). Most of the studies (92%) showed an increase in oxygenation in patients when performed in the prone position. The duration of the pronation position varies from 35 minutes – 12 hours in 24 hours. The pronation position can improve oxygenation in most COVID-19 patients who receive non-invasive oxygen therapy. In conclusion, the pronation position is an intervention that is safe and feasible to implement in conscious COVID-19 patients but with close monitoring from trained health workers.
Keywords: COVID-19, Oxygenation, Pronation Position, Non-Invasive Oxygen Therapy
References
Anand, S., Baishya, M., Singh, A., & Khanna, P. (2021). Effect of Awake Prone Positioning in COVID-19 Patients- A Systematic Review. Trends in Anaesthesia and Critical Care, 36, 17–22. https://doi.org/10.1016/j.tacc.2020.09.008
Bamford, P., Bentley, A., Dean, J., Whitmore, D., & Wilson-Baig, N. (2020). ICS Guidance for Prone Positioning of the Conscious COVID Patient 2020. Intensive Care Society
Chad, T., & Sampson, C. (2020). Prone Positioning in Conscious Patients on Medical Wards: A Review of the Evidence and Its Relevance to Patients with COVID-19 Infection. Clin Med (Lond), 20(4), e97–e103. https://doi.org/10.7861/clinmed.2020-0179
Coppo, A., Bellani, G., Winterton, D., Di-Pierro, M., Soria, A., Faverio, P., Cairo, M., Mori, S., Messinesi, G., Contro, E., Bonfanti, P., Benini, A., Valsecchi, M. G., Antolini, L., & Foti, G. (2020). Feasibility and Physiological Effects of Prone Positioning in Non-Intubated Patients with Acute Respiratory Failure Due to COVID-19 (PRON-COVID): A Prospective Cohort Study. The Lancet Respiratory Medicine, 8(8), 765–774. https://doi.org/10.1016/s2213-2600(20)30268-x
Esakandari, H., Nabi-Afjadi, M., Fakkari-Afjadi, J., Farahmandian, N., Miresmaeili, S. M., & Bahreini, E. (2020). A Comprehensive Review of COVID-19 Characteristics. Biol Proced Online, 22, 19. https://doi.org/10.1186/s12575-020-00128-2
Guerin, C., Albert, R. K., Beitler, J., Gattinoni, L., Jaber, S., Marini, J. J., Munshi, L., Papazian, L., Pesenti, A., Vieillard-Baron, A., & Mancebo, J. (2020). Prone Position in ARDS Patients: Why, When, How and for Whom. Intensive Care Med, 46(12), 2385–2396. https://doi.org/10.1007/s00134-020-06306-w
Ji, Y., Ma, Z., Peppelenbosch, M. P., & Pan, Q. (2020). Potential Association Between COVID-19 Mortality and Health-Care Resource Availability. The Lancet Global Health, 8(4). https://doi.org/10.1016/s2214-109x(20)30068-1
Kharat, A., Dupuis-Lozeron, E., Cantero, C., Marti, C., Grosgurin, O., Lolachi, S., Lador, F., Plojoux, J., Janssens, J. P., Soccal, P. M., & Adler, D. (2021). Self-Proning in COVID-19 Patients on Low-Flow Oxygen Therapy: A Cluster Randomised Controlled Trial. ERJ Open Res, 7(1). https://doi.org/10.1183/23120541.00692-2020
Liu, C., Chen, Y., Chen, Y., Chen, B., Xie, G., & Chen, Y. (2021). Effects of Prone Positioning during Extracorporeal Membrane Oxygenation for Refractory Respiratory Failure: A Systematic Review. SN Compr Clin Med, 1–7. https://doi.org/10.1007/s42399-021-01008-w
Lovato, A., De-Filippis, C., & Marioni, G. (2020). Upper Airway Symptoms in Coronavirus Disease 2019 (COVID-19). Am J Otolaryngol, 41(3), 102474. https://doi.org/10.1016/j.amjoto.2020.102474
Ni, Z., Wang, K., Wang, T., Ni, Y., Huang, W., Zhu, P., & Liu, D. (2020). The Efficacy of Early Prone or Lateral Positioning in Patients with Severe COVID-19: A Single-Center Prospective Cohort. Precision Clinical Medicine, 3(4), 260-271. doi:10.1093/pcmedi/pbaa034
Parasher, A. (2020). COVID-19: Current Understanding of Its Pathophysiology, Clinical Presentation and Treatment. Postgrad Med J. https://doi.org/10.1136/postgradmedj-2020-138577
Paternoster, G., Sartini, C., Pennacchio, E., Lisanti, F., Landoni, G., & Cabrini, L. (2020). Awake Pronation with Helmet Continuous Positive Airway Pressure for COVID-19 Acute Respiratory Distress Syndrome Patients Outside the ICU: A Case Series. Med Intensiva (Engl Ed). https://doi.org/10.1016/j.medin.2020.08.008
Peng, P. W. H., Ho, P. L., & Hota, S. S. (2020). Outbreak of a New Coronavirus: What Anaesthetists Should Know. Br J Anaesth, 124(5), 497–501. https://doi.org/10.1016/j.bja.2020.02.008
Poon, W. H., Ramanathan, K., Ling, R. R., Yang, I. X., Tan, C. S., Schmidt, M., & Shekar, K. (2021). Prone Positioning during Venovenous Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis. Crit Care, 25(1), 292. https://doi.org/10.1186/s13054-021-03723-1
Simioli, F., Annunziata, A., Langella, G., Martino, M., Musella, S., & Fiorentino, G. (2021). Early Prone Positioning and Non-Invasive Ventilation in a Critical COVID-19 Subset. A Single Centre Experience in Southern Italy. Turk Thorac J, 22(1), 57–61. https://doi.org/10.5152/TurkThoracJ.2021.20158
Singh, P., Jain, P., & Deewan, H. (2020). Awake Prone Positioning in COVID-19 Patients. Indian J Crit Care Med, 24(10), 914–918. https://doi.org/10.5005/jp-journals-10071-23546
Sryma, P. B., Mittal, S., Mohan, A., Madan, K., Tiwari, P., Bhatnagar, S., Trikha, A., Dosi, R., Bhopale, S., Viswanath, R., Hadda, V., Guleria, R., & Baldwa, B. (2021). Effect of Proning in Patients with COVID-19 Acute Hypoxemic Respiratory Failure Receiving Noninvasive Oxygen Therapy. Lung India, 38(Supplement), S6–S10. https://doi.org/10.4103/lungindia.lungindia_794_20
Taboada, M., Gonzalez, M., Alvarez, A., Gonzalez, I., Garcia, J., Eiras, M., Vieito, M. D., Naveira, A., Otero, P., Campana, O., Muniategui, I., Tubio, A., Costa, J., Selas, S., Carinena, A., Martinez, A., Veiras, S., Aneiros, F., Caruezo, V., & Alvarez, J. (2021). Effectiveness of Prone Positioning in Nonintubated Intensive Care Unit Patients with Moderate to Severe Acute Respiratory Distress Syndrome by Coronavirus Disease 2019. Anesth Analg, 132(1), 25–30. https://doi.org/10.1213/ANE.0000000000005239
Tobin, M. J., Laghi, F., & Jubran, A. (2020). Caution about Early Intubation and Mechanical Ventilation in COVID-19. Ann Intensive Care, 10(1), 78. https://doi.org/10.1186/s13613-020-00692-6
Valesky, W., & Chow, L. (2020). Prone Positioning for Acute Respiratory Distress Syndrome in Adults. Acad Emerg Med, 27(6), 520–522. https://doi.org/10.1111/acem.13948
Wang, C., Wang, Z., Wang, G., Lau, J. Y., Zhang, K., & Li, W. (2021). COVID-19 in Early 2021: Current Status and Looking Forward. Signal Transduct Target Ther, 6(1), 114. https://doi.org/10.1038/s41392-021-00527-1
Wendt, C., Mobus, K., Weiner, D., Eskin, B., & Allegra, J. R. (2021). Prone Positioning of Patients with Coronavirus Disease 2019 Who Are Nonintubated in Hypoxic Respiratory Distress: Single-Site Retrospective Health Records Review. J Emerg Nurs, 47(2), 279–287 e1. https://doi.org/10.1016/j.jen.2020.12.006
WHO. (2021). Clinical Management of COVID-19: Living Guidance (pp. 1–81). WHO
Winearls, S., Swingwood, E. L., Hardaker, C. L., Smith, A. M., Easton, F. M., Millington, K. J., Hall, R. S., Smith, A., & Curtis, K. J. (2020). Early Conscious Prone Positioning in Patients with COVID-19 Receiving Continuous Positive Airway Pressure: A Retrospective Analysis. BMJ Open Respir Res, 7(1). https://doi.org/10.1136/bmjresp-2020-000711
Wormser, J., Romanet, C., & Philippart, F. (2021). Prone Position in Wards for Spontaneous Breathing COVID-19 Patients: A Retrospective Study. Ir J Med Sci. https://doi.org/10.1007/s11845-020-02479-x
Wu, Z., & McGoogan, J. M. (2020). Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA, 323(13), 1239–1242. https://doi.org/10.1001/jama.2020.2648
Bamford, P., Bentley, A., Dean, J., Whitmore, D., & Wilson-Baig, N. (2020). ICS Guidance for Prone Positioning of the Conscious COVID Patient 2020. Intensive Care Society
Chad, T., & Sampson, C. (2020). Prone Positioning in Conscious Patients on Medical Wards: A Review of the Evidence and Its Relevance to Patients with COVID-19 Infection. Clin Med (Lond), 20(4), e97–e103. https://doi.org/10.7861/clinmed.2020-0179
Coppo, A., Bellani, G., Winterton, D., Di-Pierro, M., Soria, A., Faverio, P., Cairo, M., Mori, S., Messinesi, G., Contro, E., Bonfanti, P., Benini, A., Valsecchi, M. G., Antolini, L., & Foti, G. (2020). Feasibility and Physiological Effects of Prone Positioning in Non-Intubated Patients with Acute Respiratory Failure Due to COVID-19 (PRON-COVID): A Prospective Cohort Study. The Lancet Respiratory Medicine, 8(8), 765–774. https://doi.org/10.1016/s2213-2600(20)30268-x
Esakandari, H., Nabi-Afjadi, M., Fakkari-Afjadi, J., Farahmandian, N., Miresmaeili, S. M., & Bahreini, E. (2020). A Comprehensive Review of COVID-19 Characteristics. Biol Proced Online, 22, 19. https://doi.org/10.1186/s12575-020-00128-2
Guerin, C., Albert, R. K., Beitler, J., Gattinoni, L., Jaber, S., Marini, J. J., Munshi, L., Papazian, L., Pesenti, A., Vieillard-Baron, A., & Mancebo, J. (2020). Prone Position in ARDS Patients: Why, When, How and for Whom. Intensive Care Med, 46(12), 2385–2396. https://doi.org/10.1007/s00134-020-06306-w
Ji, Y., Ma, Z., Peppelenbosch, M. P., & Pan, Q. (2020). Potential Association Between COVID-19 Mortality and Health-Care Resource Availability. The Lancet Global Health, 8(4). https://doi.org/10.1016/s2214-109x(20)30068-1
Kharat, A., Dupuis-Lozeron, E., Cantero, C., Marti, C., Grosgurin, O., Lolachi, S., Lador, F., Plojoux, J., Janssens, J. P., Soccal, P. M., & Adler, D. (2021). Self-Proning in COVID-19 Patients on Low-Flow Oxygen Therapy: A Cluster Randomised Controlled Trial. ERJ Open Res, 7(1). https://doi.org/10.1183/23120541.00692-2020
Liu, C., Chen, Y., Chen, Y., Chen, B., Xie, G., & Chen, Y. (2021). Effects of Prone Positioning during Extracorporeal Membrane Oxygenation for Refractory Respiratory Failure: A Systematic Review. SN Compr Clin Med, 1–7. https://doi.org/10.1007/s42399-021-01008-w
Lovato, A., De-Filippis, C., & Marioni, G. (2020). Upper Airway Symptoms in Coronavirus Disease 2019 (COVID-19). Am J Otolaryngol, 41(3), 102474. https://doi.org/10.1016/j.amjoto.2020.102474
Ni, Z., Wang, K., Wang, T., Ni, Y., Huang, W., Zhu, P., & Liu, D. (2020). The Efficacy of Early Prone or Lateral Positioning in Patients with Severe COVID-19: A Single-Center Prospective Cohort. Precision Clinical Medicine, 3(4), 260-271. doi:10.1093/pcmedi/pbaa034
Parasher, A. (2020). COVID-19: Current Understanding of Its Pathophysiology, Clinical Presentation and Treatment. Postgrad Med J. https://doi.org/10.1136/postgradmedj-2020-138577
Paternoster, G., Sartini, C., Pennacchio, E., Lisanti, F., Landoni, G., & Cabrini, L. (2020). Awake Pronation with Helmet Continuous Positive Airway Pressure for COVID-19 Acute Respiratory Distress Syndrome Patients Outside the ICU: A Case Series. Med Intensiva (Engl Ed). https://doi.org/10.1016/j.medin.2020.08.008
Peng, P. W. H., Ho, P. L., & Hota, S. S. (2020). Outbreak of a New Coronavirus: What Anaesthetists Should Know. Br J Anaesth, 124(5), 497–501. https://doi.org/10.1016/j.bja.2020.02.008
Poon, W. H., Ramanathan, K., Ling, R. R., Yang, I. X., Tan, C. S., Schmidt, M., & Shekar, K. (2021). Prone Positioning during Venovenous Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis. Crit Care, 25(1), 292. https://doi.org/10.1186/s13054-021-03723-1
Simioli, F., Annunziata, A., Langella, G., Martino, M., Musella, S., & Fiorentino, G. (2021). Early Prone Positioning and Non-Invasive Ventilation in a Critical COVID-19 Subset. A Single Centre Experience in Southern Italy. Turk Thorac J, 22(1), 57–61. https://doi.org/10.5152/TurkThoracJ.2021.20158
Singh, P., Jain, P., & Deewan, H. (2020). Awake Prone Positioning in COVID-19 Patients. Indian J Crit Care Med, 24(10), 914–918. https://doi.org/10.5005/jp-journals-10071-23546
Sryma, P. B., Mittal, S., Mohan, A., Madan, K., Tiwari, P., Bhatnagar, S., Trikha, A., Dosi, R., Bhopale, S., Viswanath, R., Hadda, V., Guleria, R., & Baldwa, B. (2021). Effect of Proning in Patients with COVID-19 Acute Hypoxemic Respiratory Failure Receiving Noninvasive Oxygen Therapy. Lung India, 38(Supplement), S6–S10. https://doi.org/10.4103/lungindia.lungindia_794_20
Taboada, M., Gonzalez, M., Alvarez, A., Gonzalez, I., Garcia, J., Eiras, M., Vieito, M. D., Naveira, A., Otero, P., Campana, O., Muniategui, I., Tubio, A., Costa, J., Selas, S., Carinena, A., Martinez, A., Veiras, S., Aneiros, F., Caruezo, V., & Alvarez, J. (2021). Effectiveness of Prone Positioning in Nonintubated Intensive Care Unit Patients with Moderate to Severe Acute Respiratory Distress Syndrome by Coronavirus Disease 2019. Anesth Analg, 132(1), 25–30. https://doi.org/10.1213/ANE.0000000000005239
Tobin, M. J., Laghi, F., & Jubran, A. (2020). Caution about Early Intubation and Mechanical Ventilation in COVID-19. Ann Intensive Care, 10(1), 78. https://doi.org/10.1186/s13613-020-00692-6
Valesky, W., & Chow, L. (2020). Prone Positioning for Acute Respiratory Distress Syndrome in Adults. Acad Emerg Med, 27(6), 520–522. https://doi.org/10.1111/acem.13948
Wang, C., Wang, Z., Wang, G., Lau, J. Y., Zhang, K., & Li, W. (2021). COVID-19 in Early 2021: Current Status and Looking Forward. Signal Transduct Target Ther, 6(1), 114. https://doi.org/10.1038/s41392-021-00527-1
Wendt, C., Mobus, K., Weiner, D., Eskin, B., & Allegra, J. R. (2021). Prone Positioning of Patients with Coronavirus Disease 2019 Who Are Nonintubated in Hypoxic Respiratory Distress: Single-Site Retrospective Health Records Review. J Emerg Nurs, 47(2), 279–287 e1. https://doi.org/10.1016/j.jen.2020.12.006
WHO. (2021). Clinical Management of COVID-19: Living Guidance (pp. 1–81). WHO
Winearls, S., Swingwood, E. L., Hardaker, C. L., Smith, A. M., Easton, F. M., Millington, K. J., Hall, R. S., Smith, A., & Curtis, K. J. (2020). Early Conscious Prone Positioning in Patients with COVID-19 Receiving Continuous Positive Airway Pressure: A Retrospective Analysis. BMJ Open Respir Res, 7(1). https://doi.org/10.1136/bmjresp-2020-000711
Wormser, J., Romanet, C., & Philippart, F. (2021). Prone Position in Wards for Spontaneous Breathing COVID-19 Patients: A Retrospective Study. Ir J Med Sci. https://doi.org/10.1007/s11845-020-02479-x
Wu, Z., & McGoogan, J. M. (2020). Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA, 323(13), 1239–1242. https://doi.org/10.1001/jama.2020.2648
Published
2021-12-07
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Articles
Copyright (c) 2021 Komang Noviantari, Sri Yona, Riri Maria
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