Background/Aim: Evidence suggests a beneficial effect of prone positioning (PP) in COVID-19.Materials and Methods: Meta-analysis of individual (7 investigators' groups) and aggregate data (PubMed/EMBASE) regarding the impact of PP on the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PO2/FiO(2)) in patients with COVID-19.Results: Among 121 patients (mean age +/- SD 59.1 +/- 10.7 years, 55% males, 57% intubated) the mean post versus pre-PP PO2/FiO(2) difference was: (i) 50.4 +/- 64.3 mmHg, p<0.01, (ii) similar in awake (58.7 +/- 72.1 mmHg) versus intubated patients (44.1 +/- 57.5 mmHg, p=NS), (iii) inversely correlated with body mass index (r=-0.43, p<0.01). Meta analysis of 23 studies (n=547, weighted age 58.3 +/- 4.1, 73% males, 59% intubated) showed a pooled PO2/FiO(2) difference of 61.8 [95% confidence intervals=49.9-73.6] mmHg. Meta regression analysis revealed no associations with baseline demographics, the time in PP before assessment, and the risk of bias of the studies.Conclusion: PP seems to improve oxygenation of patients with COVID-19.
Prone Positioning in Patients With COVID-19: Analysis of Multicenter Registry Data and Meta-analysis of Aggregate Data
Barone-Adesi, Francesco
2022-01-01
Abstract
Background/Aim: Evidence suggests a beneficial effect of prone positioning (PP) in COVID-19.Materials and Methods: Meta-analysis of individual (7 investigators' groups) and aggregate data (PubMed/EMBASE) regarding the impact of PP on the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PO2/FiO(2)) in patients with COVID-19.Results: Among 121 patients (mean age +/- SD 59.1 +/- 10.7 years, 55% males, 57% intubated) the mean post versus pre-PP PO2/FiO(2) difference was: (i) 50.4 +/- 64.3 mmHg, p<0.01, (ii) similar in awake (58.7 +/- 72.1 mmHg) versus intubated patients (44.1 +/- 57.5 mmHg, p=NS), (iii) inversely correlated with body mass index (r=-0.43, p<0.01). Meta analysis of 23 studies (n=547, weighted age 58.3 +/- 4.1, 73% males, 59% intubated) showed a pooled PO2/FiO(2) difference of 61.8 [95% confidence intervals=49.9-73.6] mmHg. Meta regression analysis revealed no associations with baseline demographics, the time in PP before assessment, and the risk of bias of the studies.Conclusion: PP seems to improve oxygenation of patients with COVID-19.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
