Effectiveness of a Protective Ventilatory Strategy Using Prone Decubitus in Patients with Severe Acute Respiratory Syndrome (SARS) after Covid-19: Integrate Review

Abstract

Objective: The main objective of the present study is to investigate the effectiveness of the ventilatory strategy in decubitus in the prone position in patients with severe acute respiratory syndrome triggered by Covid-19. Method: This is an integrative literature review combined with the snowball technique, based on the following question: “What are the effects of the protective ventilatory strategy in prone decubitus in patients with SARS secondary to Covid-19? PUBMED and Academic Google were used as database, using the descriptors Artificial Respiration, Mechanical Ventilation, Cannula nasal high-flow, Pronation and Covid-19, from March 2020 to April 2021. Results: Seven articles were analyzed. The theoretical bases that supported this study are based on various sources, but may have as guiding elements the publications of the Ministry of Health, establishing an overview of conducts in respiratory treatments during the pandemic, combined with empirical research and perspectives, noting that in 10 SARS patients, all intubated, 6 of them were submitted to standard and PP position, 3 to PP and 1 only to standard, with satisfactory results. Similar research indicates that the prone position provides an increase in saturation to 95.9%, a decrease in pain complaints, an improvement in oxygenation and a decrease in mortality. Conclusion: The findings obtained from this scenario involving the various sources consulted were that the practice based on scientific evidence ensures quality care and offers subsidies that provide knowledge and updating. Although PP has been elucidated since 2008, with the pandemic this became more evident and showed that it is effective in improving the oxygenation of patients with a PaO 2 /FiO 2 ratio ≤ 150 mmHg and safe to be applied, as long as the institution train and qualify the team involved in the maneuver process and that they have strict controls and follow-up on possible complications.