Effectiveness of prone position with its moderating factors in non-intubated acute respiratory distress syndrome patients: a meta-analysis
Dublin Core
Title
Effectiveness of prone position with its moderating factors in non-intubated acute respiratory distress syndrome patients: a meta-analysis
Subject
ARDS, awake prone positioning, intubation rate, length of stay, mortality, oxygenation
Description
Introduction: While numerous meta-analyses have explored the efficacy of awake prone position (APP), most have
concentrated solely on intubation rate among Covid-19 patients without comprehensively identifying the influencing
factors. This study aims to evaluate the efficacy of APP along with its moderating factors on oxygenation, intubation
rate, and mortality in non-intubated acute respiratory distress syndrome (ARDS) patients.
Methods: We conducted a systematic search in PubMed, Web of Science, and CINAHL from inception to December
2022. JBI critical appraisal tools were used to assess the study quality. Random-effects model was employed to
calculate pooled standardized mean difference for continuous outcomes and risk ratio for dichotomous outcomes.
Results: Among the 39 studies included, most patients were suffering from Covid-19, using conventional oxygen
therapy, and receiving APP outside the ICU. APP significantly improved the PaO2/FiO2 ratio (SMD=0.70, 95% CI=0.51-
0.88) and SpO2/FiO2 ratio (SMD=0.76, 95% CI=0.51-1.01), while also reducing the risk of intubation (RR=0.66, 95%
CI=0.51-0.85) and mortality (RR=0.62, 95% CI=0.49-0.78). Factors including severity, respiratory device, body mass
index, detail of position, use of medication assistance, total duration, follow-up time, position at follow-up, and study
design significantly influence the effectiveness of APP. APP did not lead to significant improvements in length of stay
and adverse events
Conclusions: APP is a safe and beneficial intervention, enhancing oxygenation and reducing intubation and mortality
rates in non-intubated ARDS patients. Importantly, various patient and intervention characteristics should be taken
into account when implementing APP. Further well-designed experimental studies are needed to strengthen the
evidence base.
concentrated solely on intubation rate among Covid-19 patients without comprehensively identifying the influencing
factors. This study aims to evaluate the efficacy of APP along with its moderating factors on oxygenation, intubation
rate, and mortality in non-intubated acute respiratory distress syndrome (ARDS) patients.
Methods: We conducted a systematic search in PubMed, Web of Science, and CINAHL from inception to December
2022. JBI critical appraisal tools were used to assess the study quality. Random-effects model was employed to
calculate pooled standardized mean difference for continuous outcomes and risk ratio for dichotomous outcomes.
Results: Among the 39 studies included, most patients were suffering from Covid-19, using conventional oxygen
therapy, and receiving APP outside the ICU. APP significantly improved the PaO2/FiO2 ratio (SMD=0.70, 95% CI=0.51-
0.88) and SpO2/FiO2 ratio (SMD=0.76, 95% CI=0.51-1.01), while also reducing the risk of intubation (RR=0.66, 95%
CI=0.51-0.85) and mortality (RR=0.62, 95% CI=0.49-0.78). Factors including severity, respiratory device, body mass
index, detail of position, use of medication assistance, total duration, follow-up time, position at follow-up, and study
design significantly influence the effectiveness of APP. APP did not lead to significant improvements in length of stay
and adverse events
Conclusions: APP is a safe and beneficial intervention, enhancing oxygenation and reducing intubation and mortality
rates in non-intubated ARDS patients. Importantly, various patient and intervention characteristics should be taken
into account when implementing APP. Further well-designed experimental studies are needed to strengthen the
evidence base.
Creator
Julianus Yudhistira Tan1
* , Via Eliadora Togatorop2
, Dheni Koerniawan3
, Cecep Eli Kosasih4
,
and Henny Suzana Mediani5
* , Via Eliadora Togatorop2
, Dheni Koerniawan3
, Cecep Eli Kosasih4
,
and Henny Suzana Mediani5
Source
http://dx.doi.org/10.20473/jn.v19i4.60687
Date
18 November 2024
Contributor
PERI IRAWAN
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Julianus Yudhistira Tan1
* , Via Eliadora Togatorop2
, Dheni Koerniawan3
, Cecep Eli Kosasih4
,
and Henny Suzana Mediani5, “Effectiveness of prone position with its moderating factors in non-intubated acute respiratory distress syndrome patients: a meta-analysis,” Repository Horizon University Indonesia, accessed February 21, 2026, https://repository.horizon.ac.id/items/show/11095.