Prevalence of adverse events in pronated intubated adult COVID-19 patients: A systematic review with meta-analysis

AimTo present the pooled estimated prevalence of adverse events in pronated intubated adult COVID-19 patients. DesignA systematic review and meta-analysis. Data sourcesThis study used the Cochrane Library, CINAHL, Embase, LILACS, Livivo, PubMed, Scopus, and Web of Science databases as data sources. MethodsThe studies were meta-analysed using JAMOVI 1.6.15 software. A random-effects model was used to identify the global prevalence of adverse events, confidence intervals and the heterogeneity data. Risk of bias was assessed using the Joanna Briggs Institute tool, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. ResultsOf the 7904 studies identified, 169 were included for full reading, and 10 were included in the review. The most prevalent adverse events were pressure injuries (59%), haemodynamic instability (23%), death (17%) and device loss or traction (9%). ConclusionThe most prevalent adverse events in mechanically ventilated pronated patients with COVID-19 are pressure injuries, presence of haemodynamic instability, death and device loss or traction. Implications for the patient careThe evidence identified in this review can help improve the quality and safety of patient care by helping to design care protocols to avoid the development of adverse events that can cause permanent sequelae in these patients. ImpactThis systematic review addressed the adverse events related to prone position in intubated adult COVID-19 patients. We identified that the most prevalent adverse events in these patients were pressure injuries, haemodynamic instability, device loss or traction and death. The results of this review may influence the clinical practice of nurses who work in intensive care units and, consequently, the nursing care provided not only to COVID-19 patients but for all intubated patients due to other reasons in intensive care units. Reporting methodThis systematic review adhered to the PRISMA reporting guideline. Patient or public contributionAs this is a systematic review, we analysed data from primary studies conducted by many researchers. Thus, there was no patient or public contribution in this review.

Automated summary

This is a systematic review and meta-analysis on the adverse events in pronated intubated adult COVID-19 patients. The most prevalent adverse events identified were pressure injuries, haemodynamic instability, death, and device loss or traction.