tetano
Editor, Senior Moderator
Intensive Crit Care Nurs
. 2022 Apr 11;103257.
doi: 10.1016/j.iccn.2022.103257. Online ahead of print.
Effectiveness of prone position in acute respiratory distress syndrome and moderating factors of obesity class and treatment durations for COVID-19 patients: A meta-analysis
Fauzi Ashra[SUP] 1 [/SUP], Ruey Chen[SUP] 2 [/SUP], Xiao Linda Kang[SUP] 3 [/SUP], Kai-Jo Chiang[SUP] 4 [/SUP], Li-Chung Pien[SUP] 5 [/SUP], Hsiu-Ju Jen[SUP] 6 [/SUP], Doresses Liu[SUP] 7 [/SUP], Shu-Tai Shen Hsiao[SUP] 8 [/SUP], Kuei-Ru Chou[SUP] 9 [/SUP]
Affiliations
Abstract
Objectives: To examine the effectiveness of prone positioning on COVID-19 patients with acute respiratory distress syndrome with moderating factors in both traditional prone positioning (invasive mechanical ventilation) and awake self-prone positioning patients (non-invasive ventilation).
Research methodology: A comprehensive search was conducted in CINAHL, Cochrane library, Embase, Medline-OVID, NCBI SARS-CoV-2 Resources, ProQuest, Scopus, and Web of Science without language restrictions. All studies with prospective and experimental designs evaluating the effect of prone position patients with COVID-19 related to acute respiratory distress syndrome were included. Pooled standardised mean differences were calculated after prone position for primary (PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB]) and secondary outcomes (SpO[SUB]2[/SUB] and PaO[SUB]2[/SUB]) RESULTS: A total of 15 articles were eligible and included in the final analysis. Prone position had a statistically significant effect in improving PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] with standardised mean difference of 1.10 (95%CI 0.60-1.59), SpO[SUB]2[/SUB] with standardised mean difference of 3.39 (95% CI 1.30-5.48), and PaO[SUB]2[/SUB] with standardised mean difference of 0.77 (95% CI 0.19-1.35). Patients with higher body mass index and longer duration/day are associated with larger standardised mean difference effect sizes for prone positioning.
Conclusions: Our findings demonstrate that prone position significantly improved oxygen saturation in COVID-19 patients with acute respiratory distress syndrome in both traditional prone positioning and awake self-prone positioning patients. Prone position should be recommended for patients with higher body mass index and longer durations to obtain the maximum effect.
Keywords: Acute respiratory distress syndrome; COVID-19; Coronavirus 2; Prone position; Respiratory failure.
. 2022 Apr 11;103257.
doi: 10.1016/j.iccn.2022.103257. Online ahead of print.
Effectiveness of prone position in acute respiratory distress syndrome and moderating factors of obesity class and treatment durations for COVID-19 patients: A meta-analysis
Fauzi Ashra[SUP] 1 [/SUP], Ruey Chen[SUP] 2 [/SUP], Xiao Linda Kang[SUP] 3 [/SUP], Kai-Jo Chiang[SUP] 4 [/SUP], Li-Chung Pien[SUP] 5 [/SUP], Hsiu-Ju Jen[SUP] 6 [/SUP], Doresses Liu[SUP] 7 [/SUP], Shu-Tai Shen Hsiao[SUP] 8 [/SUP], Kuei-Ru Chou[SUP] 9 [/SUP]
Affiliations
- PMID: 35672215
- DOI: 10.1016/j.iccn.2022.103257
Abstract
Objectives: To examine the effectiveness of prone positioning on COVID-19 patients with acute respiratory distress syndrome with moderating factors in both traditional prone positioning (invasive mechanical ventilation) and awake self-prone positioning patients (non-invasive ventilation).
Research methodology: A comprehensive search was conducted in CINAHL, Cochrane library, Embase, Medline-OVID, NCBI SARS-CoV-2 Resources, ProQuest, Scopus, and Web of Science without language restrictions. All studies with prospective and experimental designs evaluating the effect of prone position patients with COVID-19 related to acute respiratory distress syndrome were included. Pooled standardised mean differences were calculated after prone position for primary (PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB]) and secondary outcomes (SpO[SUB]2[/SUB] and PaO[SUB]2[/SUB]) RESULTS: A total of 15 articles were eligible and included in the final analysis. Prone position had a statistically significant effect in improving PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] with standardised mean difference of 1.10 (95%CI 0.60-1.59), SpO[SUB]2[/SUB] with standardised mean difference of 3.39 (95% CI 1.30-5.48), and PaO[SUB]2[/SUB] with standardised mean difference of 0.77 (95% CI 0.19-1.35). Patients with higher body mass index and longer duration/day are associated with larger standardised mean difference effect sizes for prone positioning.
Conclusions: Our findings demonstrate that prone position significantly improved oxygen saturation in COVID-19 patients with acute respiratory distress syndrome in both traditional prone positioning and awake self-prone positioning patients. Prone position should be recommended for patients with higher body mass index and longer durations to obtain the maximum effect.
Keywords: Acute respiratory distress syndrome; COVID-19; Coronavirus 2; Prone position; Respiratory failure.