COVID-19 oldukça bulaşıcı ve yüksek mortalite ve morbiditeye sahip bir hastalıktır. SARS-CoV-2 sürecindeki hastaların bakımları sırasında aerosol salınımına neden olan prosedürlerden biri kardiyopulmoner resüsitasyondur (KPR). Bu işlem sırasında sağlık çalışanlarının güvenliğine riske atmadan spontan dolaşımın geri dönüşünün sağlanması esastır ve göğüs kompresyonları geleneksel olarak supin pozisyonda uygulanmaktadır. Prone pozisyon, cerrahi sırasında kolay erişim için ve ARDS hastalarında daha iyi oksijenizasyon için kullanılmaktadır. Bu pozisyonun artan kullanımına rağmen, prone KPR konusunda sağlık çalışanları yeterli bilgiye sahip olmayabilir.
Eisenberg MS, Bergner L, Hallstrom A. Cardiac resuscitation in the community: importance of rapid provision and implications of program planning. JAMA 1979;241:1905-1907.
Rudikoff MT, Maughan WL, Effron M, Freund P, Weisfeldt ML. Mechanisms of blood flow during cardiopulmonary resuscitation. Circulation 1980;61:345-52.
Georgiou M, Papathanassoglou E, Xanthos T. Systematic review of the mechanisms driving effective blood flow during adult CPR. Resuscitation 2014;85:1586‑93.
Edelson DP, Sasson C, Chan PS, et al. Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With The Guidelines-Resuscitation Adult and Pediatric Task Forces of the American Heart Association. Circulation. 2020 Jun 23;141(25):e933-e943. doi: 10.1161/CIRCULATIONAHA.120.047463. Epub 2020 Apr 9.
Van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020; 382(16):1564–1567. doi:10.1056/NEJMc2004973.
Bloomfield R, Noble DW, Sudlow A. Prone position for acute respiratory failure in adults. Cochrane Database Syst Rev 2015;2015:CD008095.
Zhan L, Yang LJ, Huang Y, He Q, Liu GJ. Continuous chest compression versus interrupted chest compression for cardiopulmonary resuscitation of non-asphyxial out-of-hospital cardiac arrest (Review) Cochrane Database of Systematic Reviews 2017, Issue 3. Art. No: CD010134
Re-evaluation of cardiopulmonary resuscitation. Resuscitation 1989;18:1–5.
Brown J, Roger J, Soar J. Cardiac arrest during surgery and ventilation in the prone position: a case report and systematic review. Resuscitation 2001;50:233–8.
Mazer SP, Weisfeldt M, Bai D, et al. Reverse CPR: a pilot study of CPR in the prone position. Resuscitation 2003;57:279–85.
Wei J, Tung D, Sue SH, Wu SV, Chuang YC, Chang CY. Cardiopulmonary resuscitation in prone position: A simplified method for outpatients. J Chin Med Assoc 2006;69:202-6.
Bloomfield R, Noble DW, Sudlow A, and Cochrane Emergency and Critical Care Group. Prone position for acute respiratory failure in adults.Cochrane Database Syst Rev. 2015 Nov; 2015(11): CD008095.
Ding L, Wang L, Ma W, He H. Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS: a multi-center prospective cohort study. Crit Care 2020;24:28.
Bhatraju PK, Ghassemieh BJ, Nichols M, et al. COVID-19 in critically ill patients in the Seattle region: case series. New Eng J Med. 2020:382; 2012–2012. doi: 10.1056/NEJMoa2004500
Guo T, Fan Y, Chen M, Wu X, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19) [published online March 27, 2020]. JAMA Cardiol. doi: 10.1001/jamacardio.2020.1017
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. doi: 10.1016/S0140-6736(20)30183-5
Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323:1061–1069. doi: 10.1001/jama.2020.1585.
Re-evaluation of cardiopulmonary resuscitation. Resuscitation 1989;18:1–5.
Stewart J. Resuscitating an idea: prone CPR. Resuscitation2002;54:231–6.
Sun W, Huang F, Kung K, Fan S, Chen T. Successful Cardiopulmonary resuscitation of two patients in the prone position using reversed precordial compression. Anesthesiology 1992;77(1):202–4.
Dequin P-F, Hazouard E, Legras A, Lanotte R, Perrotin D. Cardiopulmonary resuscitation in the prone position: kouwenhoven revisited. Intensive Care Med 1996;22:1272
Gomes D de S, Bersot CDA. Cardiopulmonary resuscitation in the prone position. Open Journal of Anesthesiology 2012; 2: 199-201
Kwon MJ, Kim EH, Song IK, Lee JH, Kim HS, Kim JT. Optimizing prone cardiopulmonary resuscitation: Identifying the vertebral level correlating with the largest left ventricle crosssectional area via computed tomography scan. Anesth Analg 2017;124:520-3.
Link MS, Atkins DL, Passman RS, et al. Part 6: Electrical therapies: Automated external defibrillators, defibrillation, cardioversion, and pacing: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2010;122 18 Suppl 3:S706‑19.
Resuscitation Council (UK) to produce its Management of cardiac arrest during neurosurgery in adults guidance.
Brown J, Roger J, Soar J. Cardiac arrest during surgery and ventilation in the prone position: a case report and systematic review. Resuscitation 2001;50:233–8.
Neumar RW, Otto CW, Link MS, et al. Adult Advanced Cardiovascular Life Support. Circulation. 2010;122:S729–S767.
Edelson DP, Sasson C, Chan PS, et al. Interim Guidance for B asic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19. Circulation. 2020;141:e933–e943
COVID-19 is highly contagious and has high mortality and morbidity. One of the aerosol generating procedure during management of SARS-CoV-2 patients is cardiopulmonary resuscitation (CPR). During CPR, it is essential to provide return of spontanous circulation without compromising the safety of healthcare workers and chest compressions are provided in supine position traditionally. Prone position is used during surgery for easy access and in ARDS patients for better oxygenation. Despite increasing usage of it, healthcare workers may not have enough information about prone CPR.
Eisenberg MS, Bergner L, Hallstrom A. Cardiac resuscitation in the community: importance of rapid provision and implications of program planning. JAMA 1979;241:1905-1907.
Rudikoff MT, Maughan WL, Effron M, Freund P, Weisfeldt ML. Mechanisms of blood flow during cardiopulmonary resuscitation. Circulation 1980;61:345-52.
Georgiou M, Papathanassoglou E, Xanthos T. Systematic review of the mechanisms driving effective blood flow during adult CPR. Resuscitation 2014;85:1586‑93.
Edelson DP, Sasson C, Chan PS, et al. Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With The Guidelines-Resuscitation Adult and Pediatric Task Forces of the American Heart Association. Circulation. 2020 Jun 23;141(25):e933-e943. doi: 10.1161/CIRCULATIONAHA.120.047463. Epub 2020 Apr 9.
Van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020; 382(16):1564–1567. doi:10.1056/NEJMc2004973.
Bloomfield R, Noble DW, Sudlow A. Prone position for acute respiratory failure in adults. Cochrane Database Syst Rev 2015;2015:CD008095.
Zhan L, Yang LJ, Huang Y, He Q, Liu GJ. Continuous chest compression versus interrupted chest compression for cardiopulmonary resuscitation of non-asphyxial out-of-hospital cardiac arrest (Review) Cochrane Database of Systematic Reviews 2017, Issue 3. Art. No: CD010134
Re-evaluation of cardiopulmonary resuscitation. Resuscitation 1989;18:1–5.
Brown J, Roger J, Soar J. Cardiac arrest during surgery and ventilation in the prone position: a case report and systematic review. Resuscitation 2001;50:233–8.
Mazer SP, Weisfeldt M, Bai D, et al. Reverse CPR: a pilot study of CPR in the prone position. Resuscitation 2003;57:279–85.
Wei J, Tung D, Sue SH, Wu SV, Chuang YC, Chang CY. Cardiopulmonary resuscitation in prone position: A simplified method for outpatients. J Chin Med Assoc 2006;69:202-6.
Bloomfield R, Noble DW, Sudlow A, and Cochrane Emergency and Critical Care Group. Prone position for acute respiratory failure in adults.Cochrane Database Syst Rev. 2015 Nov; 2015(11): CD008095.
Ding L, Wang L, Ma W, He H. Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS: a multi-center prospective cohort study. Crit Care 2020;24:28.
Bhatraju PK, Ghassemieh BJ, Nichols M, et al. COVID-19 in critically ill patients in the Seattle region: case series. New Eng J Med. 2020:382; 2012–2012. doi: 10.1056/NEJMoa2004500
Guo T, Fan Y, Chen M, Wu X, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19) [published online March 27, 2020]. JAMA Cardiol. doi: 10.1001/jamacardio.2020.1017
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. doi: 10.1016/S0140-6736(20)30183-5
Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323:1061–1069. doi: 10.1001/jama.2020.1585.
Re-evaluation of cardiopulmonary resuscitation. Resuscitation 1989;18:1–5.
Stewart J. Resuscitating an idea: prone CPR. Resuscitation2002;54:231–6.
Sun W, Huang F, Kung K, Fan S, Chen T. Successful Cardiopulmonary resuscitation of two patients in the prone position using reversed precordial compression. Anesthesiology 1992;77(1):202–4.
Dequin P-F, Hazouard E, Legras A, Lanotte R, Perrotin D. Cardiopulmonary resuscitation in the prone position: kouwenhoven revisited. Intensive Care Med 1996;22:1272
Gomes D de S, Bersot CDA. Cardiopulmonary resuscitation in the prone position. Open Journal of Anesthesiology 2012; 2: 199-201
Kwon MJ, Kim EH, Song IK, Lee JH, Kim HS, Kim JT. Optimizing prone cardiopulmonary resuscitation: Identifying the vertebral level correlating with the largest left ventricle crosssectional area via computed tomography scan. Anesth Analg 2017;124:520-3.
Link MS, Atkins DL, Passman RS, et al. Part 6: Electrical therapies: Automated external defibrillators, defibrillation, cardioversion, and pacing: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2010;122 18 Suppl 3:S706‑19.
Resuscitation Council (UK) to produce its Management of cardiac arrest during neurosurgery in adults guidance.
Brown J, Roger J, Soar J. Cardiac arrest during surgery and ventilation in the prone position: a case report and systematic review. Resuscitation 2001;50:233–8.
Neumar RW, Otto CW, Link MS, et al. Adult Advanced Cardiovascular Life Support. Circulation. 2010;122:S729–S767.
Edelson DP, Sasson C, Chan PS, et al. Interim Guidance for B asic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19. Circulation. 2020;141:e933–e943