Prone Position and Cardiopulmonary Resuscitation in the Operating Room: A Scoping Review

Background/Objectives: Cardiopulmonary resuscitation (CPR) in the prone position (P-CPR) is described in international guidelines for specific contexts but is not commonly included in operating room algorithms. This review aims to map P-CPR interventions in adult and pediatric patients experiencing cardiac arrest in the operating room while in the prone position. Methods: A scoping review was conducted following the "PRISMA Extension for Scoping Reviews" protocol. The databases searched included PubMed, CINAHL, ScienceDirect/Elsevier, Scopus, Web of Science, and Cochrane. Eligibility criteria included studies involving adult and pediatric populations, documented cardiac arrest (with presenting rhythm and cause), P-CPR interventions, and short-term outcomes (return of spontaneous circulation) as well as long-term outcomes when available. Results: Twenty international case reports were analyzed, indicating that P-CPR is effective in the operating room setting and has a positive impact on both short-term and long-term outcomes. Conclusions: This scoping review suggests that P-CPR yields comparable outcomes to supine CPR while saving time by eliminating the need for patient repositioning. However, due to limited evidence, further research is needed. Additionally, logistical, organizational, and educational considerations must be addressed before adopting P-CPR as routine practice.