Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis

Abstract Prone position (PP) is known to improve oxygenation and reduce mortality in COVID-19 patients. This systematic review and meta-analysis aimed to determine the effects of PP on respiratory parameters and outcomes. PubMed, EMBASE, ProQuest, SCOPUS, Web of Sciences, Cochrane library, and Googl...

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Autores principales:	Fatemeh Behesht Aeen, Reza Pakzad, Mohammad Goudarzi Rad, Fatemeh Abdi, Farzaneh Zaheri, Narges Mirzadeh
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8d555713174c4cf082007bed80631425
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spelling	oai:doaj.org-article:8d555713174c4cf082007bed806314252021-12-02T15:33:13ZEffect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis10.1038/s41598-021-93739-y2045-2322https://doaj.org/article/8d555713174c4cf082007bed806314252021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93739-yhttps://doaj.org/toc/2045-2322Abstract Prone position (PP) is known to improve oxygenation and reduce mortality in COVID-19 patients. This systematic review and meta-analysis aimed to determine the effects of PP on respiratory parameters and outcomes. PubMed, EMBASE, ProQuest, SCOPUS, Web of Sciences, Cochrane library, and Google Scholar were searched up to 1st January 2021. Twenty-eight studies were included. The Cochran's Q-test and I2 statistic were assessed heterogeneity, the random-effects model was estimated the pooled mean difference (PMD), and a meta-regression method has utilized the factors affecting heterogeneity between studies. PMD with 95% confidence interval (CI) of PaO2/FIO2 Ratio in before–after design, quasi-experimental design and in overall was 55.74, 56.38, and 56.20 mmHg. These values for Spo2 (Sao2) were 3.38, 17.03, and 7.58. PP in COVID-19 patients lead to significantly decrease of the Paco2 (PMD: − 8.69; 95% CI − 14.69 to − 2.69 mmHg) but significantly increase the PaO2 (PMD: 37.74; 95% CI 7.16–68.33 mmHg). PP has no significant effect on the respiratory rate. Based on meta-regression, the study design has a significant effect on the heterogeneity of Spo2 (Sao2) (Coefficient: 12.80; p < 0.001). No significant associations were observed for other respiratory parameters with sample size and study design. The pooled estimate for death rate and intubation rates were 19.03 (8.19–32.61) and 30.68 (21.39–40.75). The prone positioning was associated with improved oxygenation parameters and reduced mortality and intubation rate in COVID-19 related respiratory failure.Fatemeh Behesht AeenReza PakzadMohammad Goudarzi RadFatemeh AbdiFarzaneh ZaheriNarges MirzadehNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-16 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Fatemeh Behesht Aeen Reza Pakzad Mohammad Goudarzi Rad Fatemeh Abdi Farzaneh Zaheri Narges Mirzadeh Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis
description	Abstract Prone position (PP) is known to improve oxygenation and reduce mortality in COVID-19 patients. This systematic review and meta-analysis aimed to determine the effects of PP on respiratory parameters and outcomes. PubMed, EMBASE, ProQuest, SCOPUS, Web of Sciences, Cochrane library, and Google Scholar were searched up to 1st January 2021. Twenty-eight studies were included. The Cochran's Q-test and I2 statistic were assessed heterogeneity, the random-effects model was estimated the pooled mean difference (PMD), and a meta-regression method has utilized the factors affecting heterogeneity between studies. PMD with 95% confidence interval (CI) of PaO2/FIO2 Ratio in before–after design, quasi-experimental design and in overall was 55.74, 56.38, and 56.20 mmHg. These values for Spo2 (Sao2) were 3.38, 17.03, and 7.58. PP in COVID-19 patients lead to significantly decrease of the Paco2 (PMD: − 8.69; 95% CI − 14.69 to − 2.69 mmHg) but significantly increase the PaO2 (PMD: 37.74; 95% CI 7.16–68.33 mmHg). PP has no significant effect on the respiratory rate. Based on meta-regression, the study design has a significant effect on the heterogeneity of Spo2 (Sao2) (Coefficient: 12.80; p < 0.001). No significant associations were observed for other respiratory parameters with sample size and study design. The pooled estimate for death rate and intubation rates were 19.03 (8.19–32.61) and 30.68 (21.39–40.75). The prone positioning was associated with improved oxygenation parameters and reduced mortality and intubation rate in COVID-19 related respiratory failure.
format	article
author	Fatemeh Behesht Aeen Reza Pakzad Mohammad Goudarzi Rad Fatemeh Abdi Farzaneh Zaheri Narges Mirzadeh
author_facet	Fatemeh Behesht Aeen Reza Pakzad Mohammad Goudarzi Rad Fatemeh Abdi Farzaneh Zaheri Narges Mirzadeh
author_sort	Fatemeh Behesht Aeen
title	Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis
title_short	Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis
title_full	Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis
title_fullStr	Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis
title_full_unstemmed	Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis
title_sort	effect of prone position on respiratory parameters, intubation and death rate in covid-19 patients: systematic review and meta-analysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8d555713174c4cf082007bed80631425
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Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis

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