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Prone cardiopulmonary resuscitation: A scoping and expanded grey literature review for the COVID-19 pandemic

Resuscitation Jul 27, 2020

Douma MJ, Mackenzie E, Loch T, et al. - Researchers sought and summed up the available science on prone resuscitation. Further, they examined the value of performing a systematic review on this topic; and identified knowledge gaps to aid future research, education and guidelines. Searching MEDLINE, Embase, CINAHL, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, Scopus and Google Scholar, they identified 453 studies; of these, they included 24 (5%) studies. Of these, four were prone resuscitation-relevant studies examining: blood and tidal volumes generated by prone compressions; prone compression quality metrics on a manikin; and chest computed tomography scans for compression landmarking. The resuscitation of 25 prone patients was described in twenty case reports/series. This scoping review did not yield enough evidence to justify a systematic review or modified resuscitation guidelines. Resuscitation initiation in the prone position remains reasonable if turning the patient supine would result in delays or risk to providers or patients. Judgement of prone resuscitation quality can be done employing end-tidal CO2, and arterial pressure tracing, with patients turned supine if insufficient.

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