Prone Positioning terhadap Status Oksigenasi pada Pasien COVID-19
Abstract
This study systematically reviews the effectiveness of Prone Positioning on the oxygenation status of COVID-19 patients from the existing literature. The research method uses a systematic literature review and meta-analysis obtained from the google scholar database. Proquest, Pubmed, Science Direct, and Semantic Scholar. The results showed that based on oxygenation parameters, Prone Positioning had an effect on changes in the ROX index value (Mean Difference 3.89, 95% CI 0.08 to 7.70, P = 0.05), P/F Ratio (Mean Difference 17.88, 95% CI 5.44 to 30.33 , P=0.05), SPO2 (Mean Difference 1.98, 95% CI 1.29 to 2.68, P<0.00001), and S/F Ratio (Mean Difference 23.04, 95% CI 15.89 to 30.19, P <0.00001), while the respiratory rate parameters (Mean Difference -0.79, 95% CI -1.76 to -0.18, P=0.11) and PaO2 (Mean Difference 7.75, 95% CI -22.80 to -38.31, P= 0.62) did not show a significant difference. In conclusion, Prone Positioning is considered to significantly affect changes in the oxygenation of COVID-19 patients. It is expected to be a reference in implementing nursing interventions for oxygenation disorders in patients.
Keywords: COVID-19, Oxygenation, Positioning, Prone
References
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Kollias, A., Kyriakoulis, K. G., Rapti, V., Trontzas, I. P., Nitsotolis, T., Syrigos, K., & Poulakou, G. (2022). Prone Positioning in Patients with COVID-19: Analysis of Multicenter Registry Data and Meta-analysis of Aggregate Data. In vivo (Athens, Greece), 36(1), 361–370. https://doi.org/10.21873/invivo.12711
Li, J., Luo, J., Pavlov, I., Perez, Y., Tan, W., Roca, O., Tavernier, E., Kharat, A., McNicholas, B., Ibarra-Estrada, M., Vines, D. L., Bosch, N. A., Rampon, G., Simpson, S. Q., Walkey, A. J., Fralick, M., Verma, A., Razak, F., Harris, T., Laffey, J. G., Guerin, C. (2022). Awake Prone Positioning for Non-Intubated Patients with COVID-19-Related Acute Hypoxaemic Respiratory Failure: A Systematic Review and Meta-Analysis. The Lancet. Respiratory Medicine, 10(6), 573–583. https://doi.org/10.1016/S2213-2600(22)00043-1
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Pb, S., Mittal, S., Madan, K., Mohan, A., Tiwari, P., Hadda, V., Pandey, R. M., & Guleria, R. (2021). Awake Prone Positioning in Non-Intubated Patients for the Management of Hypoxemia in COVID-19: A Systematic Review and Meta-Analysis. Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace, 91(2), 10.4081/monaldi.2021.1623. https://doi.org/10.4081/monaldi.2021.1623
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Rossi, S., Palumbo, M. M., Sverzellati, N., Busana, M., Malchiodi, L., Bresciani, P., Ceccarelli, P., Sani, E., Romitti, F., Bonifazi, M., Gattarello, S., Steinberg, I., Palermo, P., Lazzari, S., Collino, F., Cressoni, M., Herrmann, P., Saager, L., Meissner, K., & Gattinoni, L. (2022). Mechanisms of Oxygenation Responses to Proning and Recruitment in COVID-19 Pneumonia. Intensive Care Medicine, 48(1), 56–66. https://doi.org/10.1007/s00134-021-06562-4
Roy, A., Singh, A., & Khanna, P. (2020). Oxygen Delivery Devices in COVID-19 Patients: Review and Recommendation. Bali Journal of Anesthesiology, 4(5), S3–S7. https://doi.org/10.4103/BJOA.BJOA_62_20
Sartini, C., Treoldi, M., Scarpellini, P., Tettamanti, A., Landoni, G., & Zangrillo, A. (2020). Respiratory Parameters in Patients with COVID-19 after Using Noninvasive Ventilation in the Prone Position Outside the Intensive Care Unit. Journal of the American Medical Association, 323(22), 2338–2340. https://doi.org/10.1056/nejmoa1214103
Sryma, P., Mittal, S., Mohan, A., Madan, K., Tiwari, P., Bhatnagor, 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. Indian Chest Society. https://doi.org/10.4103/lungindia.lungindia_794_20
Tan, W., Xu, D. Y., Xu, M. J., Wang, Z. F., Dai, B., Li, L. L., Zhao, H. W., Wang, W., & Kang, J. (2021). The Efficacy and Tolerance of Prone Positioning in Non-Intubation Patients with Acute Hypoxemic Respiratory Failure and ARDS: A Meta-Analysis. Therapeutic Advances in Respiratory Disease, 15, 17534666211009407. https://doi.org/10.1177/17534666211009407
Thompson, A. E., Ranard, B. L., Wei, Y., & Jelic, S. (2020). Prone Positioning in Awake, Nonintubated Patients with COVID-19 Hypoxemic Respiratory Failure. Journal of the American Medical Association, 180(11), 1537–1540. https://doi.org/10.1056/nejmoa072771
Touchon, F., Trigui, Y., Prud’Homme, E., Lefebvre, L., Giraud, A., Dols, A. M., Martinez, S., Bernardi, M., Begne, C., Granier, P., Chanez, P., Forel, J. M., Papazian, L., & Elharrar, X. (2021). Awake Prone Positioning for Hypoxaemic Respiratory Failure: Past, COVID-19 and Perspectives. European Respiratory Review, 30(160). https://doi.org/10.1183/16000617.0022-2021
Tu, G.. W., Liao, Y.. X., Li, Q. Y., Dong, H., Yang, L. Y., Zhang, X. Y., Fu, S. Z., & Wang, R. L. (2020). Prone Positioning in High-Flow Nasal Cannula for COVID-19 Patients with Severe Hypoxemia: A Pilot Study. Annals of Translational Medicine, 8(9), 598–598. https://doi.org/10.21037/atm-20-3005
Umar, T. P. (2021). Tatalaksana Ventilasi pada Pasien Coronavirus Disease 2019 (COVID-19). Damianus Journal of Medicine, 20(2), 163–171. https://doi.org/10.25170/djm.v20i2.2389
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Chua, E. X., Mohd, S., Syed, I., Zahir, M., Ng, K. T., Teoh, W. Y., Hasan, M. S., Rahayu, S., Ruslan, B., & Abosamak, M. F. (2021). Effect of Prone Versus Supine Position in COVID-19 Patients : A Systematic Review and Meta-Analysis. Journal of Clinical Anesthesia, 74(May), 110406. https://doi.org/10.1016/j.jclinane.2021.110406
Darban, M., Memarian, M., Malek, F., Bahrami, M., & Gohari, A. (2022). Comparison of Prone and Supine Status on Oxygenation of Patients with COVID-19 with Acute Hypoxemia Treated Using Reservoir Mask; A Randomized Clinical Trial. Immunopathologia Persa, 75(x). https://doi.org/10.34172/ipp.2022.27260
Ehrmann, S., Li, J., Ibarra-Estrada, M., Perez, Y., Pavlov, I., McNicholas, B., Roca, O., Mirza, S., Vines, D., Garcia-Salcido, R., Aguirre-Avalos, G., Trump, M. W., Nay, M. A., Dellamonica, J., Nseir, S., Mogri, I., Cosgrave, D., Jayaraman, D., Masclans, J. R., & Kimmoun, A. (2021). Awake Prone Positioning for COVID-19 Acute Hypoxaemic Respiratory Failure: A Randomised, Controlled, Multinational, Open-Label Meta-Trial. The Lancet Respiratory Medicine, 9(12), 1387–1395. https://doi.org/10.1016/S2213-2600(21)00356-8
Hafez, A. F., Gamal, R., El-Rahman, A., & Kamal, F. (2022). Is Prolonged Period of Prone Position Effective and Safe in Mechanically Ventilated Patients with SARS-CoV-2? A Randomized Clinical Trial. Egyptian Journal of Anaesthesia, 38(1), 276–283. https://doi.org/10.1080/11101849.2022.2077048
Ibarra-Estrada, M., Li, J., Pavlov, I., Perez, Y., Roca, O., Tavernier, E., McNicholas, B., Vines, D., MarÃn-Rosales, M., Vargas-Obieta, A., GarcÃa-Salcido, R., Aguirre-DÃaz, S. A., López-PulgarÃn, J. A., Chávez-Peña, Q., Mijangos-Méndez, J. C., Aguirre-Avalos, G., Ehrmann, S., & Laffey, J. G. (2022). Factors for Success of Awake Prone Positioning in Patients with COVID-19-Induced Acute Hypoxemic Respiratory Failure: Analysis of a Randomized Controlled Trial. Critical Care, 26(1), 1–13. https://doi.org/10.1186/s13054-022-03950-0
Jagan, N., Morrow, L. E., Walters, R. W., Klein, L. P., Wallen, T. J., Chung, J., & Plambeck, R. W. (2020). The Positioned Study: Prone Positioning in Nonventilated Coronavirus Disease 2019 Patients-A Retrospective Analysis. Critical Care Explorations, 2(10), e0229. https://doi.org/10.1097/cce.0000000000000229
Jayakumar, D., Ramachandran, D. P., Rabindrarajan, D, E., Vijayaraghavan, B. K. T., Ramakrishnan, A. N., & Venkataraman, A. R. (2021). Standard Care Versus Awake Prone Position in Adult Nonintubated Patients with Acute Hypoxemic Respiratory Failure Secondary to COVID-19 Infection—A Multicenter Feasibility Randomized Controlled Trial. Journal of Intensive Care Medicine, 36(8), 918–924. https://doi.org/10.1177/08850666211014480
Jochmans, S., Mazerand, S., Chelly, J., Pourcine, F., Sy, O., Thieulot-Rolin, N., Ellrodt, O., Rochettes, E. M., Michaud, G., Serbource-Goguel, J., Vinsonneau, C., Vong, L. V. P., & Monchi, M. (2020). Duration of Prone Position Sessions: A Prospective Cohort Study. Annals of Intensive Care, 10(1). https://doi.org/10.1186/s13613-020-00683-7
Kemenkes RI. (2021). Situasi Terkini Perkembangan Covid-19. https://covid19.kemkes.go.id/
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 Research, 7(1), 00692–02020. https://doi.org/10.1183/23120541.00692-2020
Kollias, A., Kyriakoulis, K. G., Rapti, V., Trontzas, I. P., Nitsotolis, T., Syrigos, K., & Poulakou, G. (2022). Prone Positioning in Patients with COVID-19: Analysis of Multicenter Registry Data and Meta-analysis of Aggregate Data. In vivo (Athens, Greece), 36(1), 361–370. https://doi.org/10.21873/invivo.12711
Li, J., Luo, J., Pavlov, I., Perez, Y., Tan, W., Roca, O., Tavernier, E., Kharat, A., McNicholas, B., Ibarra-Estrada, M., Vines, D. L., Bosch, N. A., Rampon, G., Simpson, S. Q., Walkey, A. J., Fralick, M., Verma, A., Razak, F., Harris, T., Laffey, J. G., Guerin, C. (2022). Awake Prone Positioning for Non-Intubated Patients with COVID-19-Related Acute Hypoxaemic Respiratory Failure: A Systematic Review and Meta-Analysis. The Lancet. Respiratory Medicine, 10(6), 573–583. https://doi.org/10.1016/S2213-2600(22)00043-1
Li, X., Geng, M., Peng, Y., Meng, L., & Lu, S. (2020). Molecular Immune Pathogenesis and Diagnosis of COVID-19. Journal of Pharmaceutical Analysis, 10(2), 102–108. https://doi.org/10.1016/J.JPHA.2020.03.001
Pb, S., Mittal, S., Madan, K., Mohan, A., Tiwari, P., Hadda, V., Pandey, R. M., & Guleria, R. (2021). Awake Prone Positioning in Non-Intubated Patients for the Management of Hypoxemia in COVID-19: A Systematic Review and Meta-Analysis. Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace, 91(2), 10.4081/monaldi.2021.1623. https://doi.org/10.4081/monaldi.2021.1623
Pikobar. (2022). Pusat Informasi dan Koordinasi COVID-19 Jawa Barat. https://pikobar.jabarprov.go.id/
Pujiastuti, D., Larasasih, L. I. N., Ismandani, R. S., Tenggara, R. M., & Purba, T. B. (2021). Efektifitas Posisi Pronasi pada Pasien COVID-19 dengan Gangguan Pernapasan Tanpa Intubasi di Ruang ICU : Literatur Review. Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing), 7(2), 326–330. https://doi.org/10.33023/jikep.v7i2.845
Qian, E. T., Gatto, C. L., Amusina, O., Dear, M. L., Hiser, W., Buie, R., Kripalani, S., Harrell, F. E., Freundlich, R. E., Gao, Y., Gong, W., Hennessy, C., Grooms, J., Mattingly, M., Bellam, S. K., Burke, J., Zakaria, A., Vasilevskis, E. E., Billings, F. T., & Rice, T. W. (2022). Assessment of Awake Prone Positioning in Hospitalized Adults with COVID-19: A Nonrandomized Controlled Trial. JAMA Internal Medicine, 182(6), 612–621. https://doi.org/10.1001/jamainternmed.2022.1070
Reddy, M. P., Subramaniam, A., Afroz, A., Billah, B., Lim, Z. J., Zubarev, A., Blecher, G., Tiruvoipati, R., Ramanathan, K., Wong, S. N., Brodie, D., Fan, E., & Shekar, K. (2021). Prone Positioning of Nonintubated Patients With Coronavirus Disease 2019-A Systematic Review and Meta-Analysis. Critical Care Medicine, 49(10), e1001–e1014. https://doi.org/10.1097/CCM.0000000000005086
Rosén, J., Oelreich, E. V., Fors, D., Fagerlund, M. J., Taxbro, K., Skorup, P., Eby, L., Jalde, F. C., Johansson, N., Bergström, G., Frykholm, P., Gradin, A., Ali, M., Lennborn, U., Bogdanovic, D., Roos, A., Modie, M., & Giesecke, J. (2021). Awake Prone Positioning in Patients with Hypoxemic Respiratory Failure Due to COVID-19: The Proflo Multicenter Randomized Clinical Trial. Critical Care, 25(1), 1–10. https://doi.org/10.1186/s13054-021-03602-9
Rossi, S., Palumbo, M. M., Sverzellati, N., Busana, M., Malchiodi, L., Bresciani, P., Ceccarelli, P., Sani, E., Romitti, F., Bonifazi, M., Gattarello, S., Steinberg, I., Palermo, P., Lazzari, S., Collino, F., Cressoni, M., Herrmann, P., Saager, L., Meissner, K., & Gattinoni, L. (2022). Mechanisms of Oxygenation Responses to Proning and Recruitment in COVID-19 Pneumonia. Intensive Care Medicine, 48(1), 56–66. https://doi.org/10.1007/s00134-021-06562-4
Roy, A., Singh, A., & Khanna, P. (2020). Oxygen Delivery Devices in COVID-19 Patients: Review and Recommendation. Bali Journal of Anesthesiology, 4(5), S3–S7. https://doi.org/10.4103/BJOA.BJOA_62_20
Sartini, C., Treoldi, M., Scarpellini, P., Tettamanti, A., Landoni, G., & Zangrillo, A. (2020). Respiratory Parameters in Patients with COVID-19 after Using Noninvasive Ventilation in the Prone Position Outside the Intensive Care Unit. Journal of the American Medical Association, 323(22), 2338–2340. https://doi.org/10.1056/nejmoa1214103
Sryma, P., Mittal, S., Mohan, A., Madan, K., Tiwari, P., Bhatnagor, 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. Indian Chest Society. https://doi.org/10.4103/lungindia.lungindia_794_20
Tan, W., Xu, D. Y., Xu, M. J., Wang, Z. F., Dai, B., Li, L. L., Zhao, H. W., Wang, W., & Kang, J. (2021). The Efficacy and Tolerance of Prone Positioning in Non-Intubation Patients with Acute Hypoxemic Respiratory Failure and ARDS: A Meta-Analysis. Therapeutic Advances in Respiratory Disease, 15, 17534666211009407. https://doi.org/10.1177/17534666211009407
Thompson, A. E., Ranard, B. L., Wei, Y., & Jelic, S. (2020). Prone Positioning in Awake, Nonintubated Patients with COVID-19 Hypoxemic Respiratory Failure. Journal of the American Medical Association, 180(11), 1537–1540. https://doi.org/10.1056/nejmoa072771
Touchon, F., Trigui, Y., Prud’Homme, E., Lefebvre, L., Giraud, A., Dols, A. M., Martinez, S., Bernardi, M., Begne, C., Granier, P., Chanez, P., Forel, J. M., Papazian, L., & Elharrar, X. (2021). Awake Prone Positioning for Hypoxaemic Respiratory Failure: Past, COVID-19 and Perspectives. European Respiratory Review, 30(160). https://doi.org/10.1183/16000617.0022-2021
Tu, G.. W., Liao, Y.. X., Li, Q. Y., Dong, H., Yang, L. Y., Zhang, X. Y., Fu, S. Z., & Wang, R. L. (2020). Prone Positioning in High-Flow Nasal Cannula for COVID-19 Patients with Severe Hypoxemia: A Pilot Study. Annals of Translational Medicine, 8(9), 598–598. https://doi.org/10.21037/atm-20-3005
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WHO. (2021). Clinical Management of COVID-19: Living Guidance. https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-clinical-2021-2
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Published
2022-10-29
Section
Articles
Copyright (c) 2022 Rohmat Rohwandi, Hotma Rumahorbo, Susilawati Susilawati, Linlin Lindayani, Asep Badru Djamaludin
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