Abstract
Objectives
Proning is an established technique for the care of intubated patients with severe
respiratory failure. Positioning devices used to support the head and body of patients
placed in the prone position are often associated with the formation of pressure injuries.
Despite robust literature on the prevention and monitoring of pressure injuries, little
is described about the role of proning pillows on pressure injuries. The objective
of this review is to understand the extent of evidence pertaining to the safety and
usability of different types of proning pillows in the intensive care setting.
Review method
A scoping review of the literature was completed using predefined search terms in
three databases and identified 296 articles. An additional 26 were included from reference
lists. Twenty studies are included in the analysis; most were published in the past
3 years, with >50% in surgical settings.
Data sources
Three databases were searched: PubMed, Scopus, and EMBASE.
Review methods
The review followed the PRISMA Extension for Scoping Reviews, and data were reviewed
using Covidence.
Results
The most prevalent proning pillow is a standard, noncontoured foam head positioner.
It is responsible for the majority of facial pressure injuries in all settings of
care. Memory foam pillows and helmet-based systems offer improved surface pressure
distribution, although their usability in the intensive care setting remains poorly
studied. Inflatable air-cell-based devices present an alternative, but the lack of
supporting research and the costs may explain their poor uptake. Several articles
proposed the use of pressure sensor systems to evaluate devices. We propose a set
of ergonomic parametres to consider when choosing or designing a positioning device
for proned patients.
Conclusion
The evidence pertaining to the safety and usability of proning pillows in the intensive
care setting is scarce, which provides opportunities for future research to improve
the efficacy in the prevention of pressure injuries and the user experience.
Keywords
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Article info
Publication history
Published online: October 28, 2022
Accepted:
August 29,
2022
Received in revised form:
August 28,
2022
Received:
March 29,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
Crown Copyright © 2022 Published by Elsevier Ltd on behalf of Australian College of Critical Care Nurses Ltd. All rights reserved.
