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Efficacy of prone position in acute respiratory distress syndrome: overview of systematic reviews

Efectividad de la posición prona en el síndrome de dificultad respiratoria aguda: panorama de revisiones sistemáticas

Abstract

OBJECTIVE

To identify and integrate the available scientific evidence related to the use of the prone position in patients with acute respiratory distress syndrome for the reduction of the outcome variable of mortality compared to the dorsal decubitus position.

METHOD

Overview of systematic reviews or meta-analyzes of randomized clinical trials. It included studies that evaluated the use of prone positioning in patients with acute respiratory distress syndrome published between 2014 and 2016. The AMSTAR tool was used to determine the methodological quality of studies. The GRADE system was used to establish the overall quality of evidence for the mortality outcome.

RESULTS

From the search strategy, were retrieved seven relevant manuscripts of high methodological quality.

CONCLUSION

Scientific evidence supports that combined use of protective ventilatory strategy and prone positioning for periods between 16 and 20 hours in patients with acute respiratory distress syndrome and PaO2/FiO2 ratio lower than 150 mm/Hg results in significant reduction of mortality rate.

Descriptors
Critical Care; Prone Position; Respiratory Distress Syndrome, Adult; Evidence-Based Nursing; Evidence-Based Practice; Review

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br