Influence of different positions on adult patients with ARDS undergoing mechanical ventilation: a network Meta-analysis
10.3760/cma.j.cn115682-20210421-01736
- VernacularTitle:不同体位对成人ARDS行机械通气患者影响的网状Meta分析
- Author:
Jieru CHEN
1
;
Mengqi WANG
;
Hongbo CHEN
;
Yuexian SHI
;
Shaomei SHANG
Author Information
1. 北京大学护理学院 100191
- Keywords:
Respiratory distress syndrome;
Respiration, artificial;
Network Meta-analysis;
Position
- From:
Chinese Journal of Modern Nursing
2021;27(31):4246-4255
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effects of different position interventions in patients with acute respiratory distress syndrome (ARDS) undergoing mechanical ventilation from the aspects of effectiveness and safety using the method of network Meta-analysis.Methods:Randomized clinical trials (RCTs) related to the therapeutic effect of position interventions in adult ARDS patients undergoing mechanical ventilation were retrieved in PubMed, Embase, Cochrane Library, Web of Science, CINAHL, China Biomedical Literature Database, China National Knowledge Infrastructure, VIP and WanFang Data. The search time limit was from the establishment of the database to January 2021. According to the literature inclusion and exclusion criteria, literature was screened and the quality evaluation and data extraction were carried out. StataSE 15 and Addis 1.16.6 were used for network Meta-analysis.Results:A total of 31 RCTs were included, involving5 positions of prone, semi-recumbent, side-recumbent, supine and sitting, and 3 738 patients. The prone position compared with the semi-recumbent position, the semi-recumbent position compared with the supine position could reduce the 28-day all-cause mortality of the patient, and the difference was statistically significant ( P<0.05) . Compared with the semi-recumbent position and the supine position, the prone position could reduce the length of time the patient stayed in the ICU, and the difference was statistically significant ( P<0.05) . The prone position could increase the oxygenation index of patients compared with the supine position, and the difference was statistically significant ( P<0.05) . For the total incidence of adverse events and adverse reactions, there was no statistically significant difference between any two positions ( P>0.05) . The network Meta probability ranking of all the outcome indicators showed that the prone position and the side-recumbent position had advantages, and the supine position and the semi-recumbent position had no obvious advantages. Conclusions:Current evidence shows that the prone and side-recumbent position interventions are effective and safe for the treatment of ARDS patients undergoing mechanical ventilation, and are good choices among several positions.
