Effects of various prone ventilation positions in patients with acute respiratory distress syndrome: a network Meta-analysis
10.3760/cma.j.cn115455-20241114-01004
- VernacularTitle:不同俯卧位通气对急性呼吸窘迫综合征患者影响的网状Meta分析
- Author:
Qiangfang YU
1
;
Xing WEI
;
Jing LI
;
Tianbo LI
;
Yong WANG
;
Sijia GU
;
Liqin CHEN
Author Information
1. 陆军军医大学第一附属医院检验科，重庆 400038
- Publication Type:Journal Article
- Keywords:
Respiratory distress syndrome, adult;
Posture;
Prone position;
Meta-analysis
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(5):398-405
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects of 5 prone ventilation positions in patients with acute respiratory distress syndrome (ARDS) with network Meta-analysis.Methods:The randomized controlled trials on various prone ventilation positions in patients with ARDS were retrieved from Cochrane Library, EMbase, CINAHL, PubMed, Web of Science, SinoMed, CNKI, Chinese Medical Association Guideline Database, Wanfang Data, China Biology Medicine disc, VIP Information and Chinese Clinical Trial Registry from their inception to December 31, 2023. Literature screening, quality assessment and data extraction were done following the inclusion and exclusion criteria. Network Meta-analysis of outcome indicators was done using Stata 18.0.Results:A total of 19 articles, covering 1 284 patients and 5 prone ventilation positions (0°, 10°, 30°, 25° and 45°) were included. Cochrane risk assessment results showed that 15 articles were grade B and 4 articles were grade C. In direct comparisons, heterogeneity was acceptable ( I2≤50% and P≥0.1). In network analysis, the global and local consistency test result showed good consistency ( P>0.05). Network Meta-analysis result showed that the incidences of pressure injury in patients with 10°, 25°, 30° and 45° prone ventilation were significantly lower than that in patients with 0° prone ventilation, the incidence of pressure injury in patients with 25° prone ventilation was significantly lower than that in patients with 10° prone ventilation, and there were statistical differences ( P<0.05); the oxygenation index in patients with 25° prone ventilation was significantly better than that in patients with 0°, 30° and 45° prone ventilation, and there was statistical difference ( P<0.05). Conclusions:The 25° prone ventilation can both effectively improve oxygenation and maximally reduce the incidence of pressure injury in patients with ARDS.
