Introduction:

A characteristic of patients with acute respiratory distress syndrome associated to COVID-19, particularly the most severely affected, is the presence of refractory hypoxemia, which may require adjuvant therapy alongside artificial mechanical ventilation, including prone positioning of the patient.

Objective:

Present the available evidence about the changes undergone by the respiratory system with the implementation of prone positioning in patients with invasive ventilation support due to acute respiratory distress associated to COVID-19, as well as its impact on mortality.

Methods:

An observational retrospective bibliographic review about the topic was conducted from February to July 2020, initially with the search engine Google Scholar, and then in the bibliographic databases CUMED, LILACS, SciELO, PubMed/Medline, EBSCO, Cochrane Library and Web of Science. The search was based on key terms such as "prone position", "acute respiratory distress syndrome", "mechanical ventilation", obtained from the Health Sciences Descriptors (DeCS). Selection criteria included papers written in English or Spanish, of a foreign or national origin, about the topic suggested by the search terms used, published in the present century, preferably in the last five years.

Conclusions:

Current guidelines recommend early use of invasive mechanical ventilation in prone position for patients with COVID-19-induced moderate-severe acute respiratory distress syndrome for 12-16 hours daily to improve oxygenation and pulmonary recruitment, and reduce mortality.

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