Effects of prone positioning on ARDS outcomes of trauma and surgical patients: a systematic review and meta-analysis
Issued Date
2023-12-01
Resource Type
eISSN
14712466
Scopus ID
2-s2.0-85179711204
Pubmed ID
38093216
Journal Title
BMC Pulmonary Medicine
Volume
23
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC Pulmonary Medicine Vol.23 No.1 (2023)
Suggested Citation
Phoophiboon V., Owattanapanich N., Owattanapanich W., Schellenberg M. Effects of prone positioning on ARDS outcomes of trauma and surgical patients: a systematic review and meta-analysis. BMC Pulmonary Medicine Vol.23 No.1 (2023). doi:10.1186/s12890-023-02805-w Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/95630
Title
Effects of prone positioning on ARDS outcomes of trauma and surgical patients: a systematic review and meta-analysis
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Prone position is an option for rescue therapy for acute respiratory distress syndrome. However, there are limited relevant data among trauma and surgical patients, who may be at increased risk for complications following position changes. This study aimed to identify the benefits and risks of proning in this patient subgroup. Methods: Follow the PRISMA 2020, MEDLINE and EMBASE database searches were conducted. Additional search of relevant primary literature and review articles was also performed. A random effects model was used to estimate the PF ratio, mortality rate, mechanical ventilator days, and intensive care unit length of stay using Review Manager 5.4.1 software. Results: Of 1,128 studies, 15 articles were included in this meta-analysis. The prone position significantly improved the PF ratio compared with the supine position (mean difference, 79.26; 95% CI, 53.38 to 105.13). The prone position group had a statistically significant mortality benefit (risk ratio [RR], 0.48; 95% CI, 0.35 to 0.67). Although there was no significant difference in the intensive care unit length of stay, the prone position significantly decreased mechanical ventilator days (-2.59; 95% CI, -4.21 to -0.97). On systematic review, minor complications were frequent, especially facial edema. There were no differences in local wound complications. Conclusions: The prone position has comparable complications to the supine position. With its benefits of increased oxygenation and decreased mortality, the prone position can be considered for trauma and surgical patients. A prospective multicenter study is warranted.