The Application of Prone Position to Improving Pulmonary Ventilation in COVID-19 Cases Treated in The ICU: Literature Review

An outbreak of a novel form of pneumonia due to a coronavirus occurred in Wuhan City, Hubei Province, China, in December 2019, and the disease was officially named coronavirus 2019 (COVID-19). COVID-19 is an infectious disease caused by the SARS-CoV-2 virus which attacks the human respiratory system. In critical cases of COVID-19, special treatment is administered in the ICU using a mechanical ventilator. However, since the results are less than optimal, additional interventions such as orienting the patient in the prone position can be employed, as this can reduce the pressure on the dorsal lung area so that alveolar recruitment can be improved. This study examines the effect of the prone position on increasing pulmonary ventilation. This study is a literature review study employing a narrative method and was conducted by tracing and analyzing articles relevant to the topic. This literature review searched three databases, namely, PubMed, Google Scholar, and ProQuest using the keywords “COVID-19 OR intubated COVID-19” AND “prone position OR mechanical ventilator” AND “Lung ventilation”. From these databases, 1062 journals were found and filtered based on inclusion and exclusion criteria, resulting in the inclusion of 10 journals. Then, they were filtered again using a critical appraisal instrument called “JBI Critical Appraisal”, which was conducted by two people, N.P. and A.S.; consequently, the results of 5 journals were obtained for further analysis; cumulatively, these papers represented a total population of 1789 patients. It was concluded that the prone position can improve pulmonary ventilation by up to 50% and reduce the total length of stay by up to 5 days in the hospital, as long as the patients do not possess any comorbid diseases.