Effect of awake prone positioning on tracheal intubation rates in patients with COVID-19: A meta-analysis
Purpose: We investigated the effect of awake prone positioning on endotracheal intubation rates in spontaneously breathing patients with COVID-19 not undergoing endotracheal intubation. Methods: We searched the CINAHL, Cochrane Library, PUBMED, MEDLINE, and Web of Science databases until December 31...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S240584402306841X |
| _version_ | 1797669847172120576 |
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| author | Dan Wen Xiuru Yang Zhenghua Liang Fenglin Yan Haiyan He Li Wan |
| author_facet | Dan Wen Xiuru Yang Zhenghua Liang Fenglin Yan Haiyan He Li Wan |
| author_sort | Dan Wen |
| collection | DOAJ |
| description | Purpose: We investigated the effect of awake prone positioning on endotracheal intubation rates in spontaneously breathing patients with COVID-19 not undergoing endotracheal intubation. Methods: We searched the CINAHL, Cochrane Library, PUBMED, MEDLINE, and Web of Science databases until December 31, 2022. Prospective randomized controlled, cohort, and case-control studies were included. A meta-analysis was performed on the primary outcome measure, tracheal intubation rates, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Ten studies with a total of 2641 patients were included. The tracheal intubation rate in the awake prone position was 34% (95%CI: 0.59–1.10; P = 0.18; I2 = 55%), showing a non-significant benefit. Mortality was lower in prone-positioned than in supine-positioned patients (odds ratio: 0.75; 95% CI: 0.61–0.93; P = 0.007; I2 = 46%), prone positioning significantly improved the PaO2/FiO2 ratio (mean difference −29.17; 95%CI: −50.91 to −7.43; P = 0.009; I2 = 44%). Conclusions: Prone positioning can improve the PaO2/FIO2 ratio in patients with COVID-19 but we found no significant effect on tracheal intubation rates. Awake prone positioning seems to be associated with lower mortality, however, and may thus be a beneficial and effective intervention for patients with COVID-19. The optimal timing, duration, and target population need to be determined in future studies. |
| first_indexed | 2024-03-11T20:50:44Z |
| format | Article |
| id | doaj.art-88612ebca269440f84da307c550ed35f |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-11T20:50:44Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-88612ebca269440f84da307c550ed35f2023-10-01T06:00:36ZengElsevierHeliyon2405-84402023-09-0199e19633Effect of awake prone positioning on tracheal intubation rates in patients with COVID-19: A meta-analysisDan Wen0Xiuru Yang1Zhenghua Liang2Fenglin Yan3Haiyan He4Li Wan5Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, ChinaMianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, ChinaMianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, ChinaMianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, ChinaMianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, ChinaDepartment of Nursing, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, China; Corresponding author. No.12 Changjia Alley, Jingzhong Street, Fucheng District, 621000 Mianyang, China.Purpose: We investigated the effect of awake prone positioning on endotracheal intubation rates in spontaneously breathing patients with COVID-19 not undergoing endotracheal intubation. Methods: We searched the CINAHL, Cochrane Library, PUBMED, MEDLINE, and Web of Science databases until December 31, 2022. Prospective randomized controlled, cohort, and case-control studies were included. A meta-analysis was performed on the primary outcome measure, tracheal intubation rates, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Ten studies with a total of 2641 patients were included. The tracheal intubation rate in the awake prone position was 34% (95%CI: 0.59–1.10; P = 0.18; I2 = 55%), showing a non-significant benefit. Mortality was lower in prone-positioned than in supine-positioned patients (odds ratio: 0.75; 95% CI: 0.61–0.93; P = 0.007; I2 = 46%), prone positioning significantly improved the PaO2/FiO2 ratio (mean difference −29.17; 95%CI: −50.91 to −7.43; P = 0.009; I2 = 44%). Conclusions: Prone positioning can improve the PaO2/FIO2 ratio in patients with COVID-19 but we found no significant effect on tracheal intubation rates. Awake prone positioning seems to be associated with lower mortality, however, and may thus be a beneficial and effective intervention for patients with COVID-19. The optimal timing, duration, and target population need to be determined in future studies.http://www.sciencedirect.com/science/article/pii/S240584402306841XAwake prone positionCOVID-19Tracheal intubationMeta-analysis |
| spellingShingle | Dan Wen Xiuru Yang Zhenghua Liang Fenglin Yan Haiyan He Li Wan Effect of awake prone positioning on tracheal intubation rates in patients with COVID-19: A meta-analysis Heliyon Awake prone position COVID-19 Tracheal intubation Meta-analysis |
| title | Effect of awake prone positioning on tracheal intubation rates in patients with COVID-19: A meta-analysis |
| title_full | Effect of awake prone positioning on tracheal intubation rates in patients with COVID-19: A meta-analysis |
| title_fullStr | Effect of awake prone positioning on tracheal intubation rates in patients with COVID-19: A meta-analysis |
| title_full_unstemmed | Effect of awake prone positioning on tracheal intubation rates in patients with COVID-19: A meta-analysis |
| title_short | Effect of awake prone positioning on tracheal intubation rates in patients with COVID-19: A meta-analysis |
| title_sort | effect of awake prone positioning on tracheal intubation rates in patients with covid 19 a meta analysis |
| topic | Awake prone position COVID-19 Tracheal intubation Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S240584402306841X |
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