A systematic review and meta-analysis of prone positioning (PP) for non-intubated COVID-19 patients was published in critical care medicine. The study aimed to systematically synthesize the outcomes associated with PP for non-intubated COVID-19 patients. The primary outcome was the reported cumulative intubation risk, while secondary outcomes included mortality, need for escalating respiratory support, hospital length of stay, ICU admission, and adverse events.
The study found that PP significantly reduced the intubation risk compared to supine position. Subgroup analysis showed a significant reduction in intubation risk among patients supported by high-flow nasal cannula (HFNC) or noninvasive ventilation (NIV) but not in patients with conventional oxygen therapy. No significant reduction was seen in mortality, need for escalating respiratory support, hospital length of stay, ICU admission and adverse events.
In conclusion, in non-intubated COVID-19 patients, PP reduced the need for intubation particularly among those requiring respiratory support with HFNC or NIV but did not reduce mortality, need for escalating respiratory support, hospital length of stay and ICU admission.
Li, Jie1; Luo, Jian2; Pavlov, Ivan3; Perez, Yonatan4; Kharat, Aileen5; Tavernier, Elsa4; Vines, David6; Roca, Oriol7; McNicholas, Bairbre8; Ibarra-Estrada, Miguel9; Laffey, John10; Guerin, Claude11; Ehrmann, Stephan12. 51: PRONE POSITIONING FOR NONINTUBATED COVID-19 PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS. Critical Care Medicine 51(1):p 26, January 2023. | DOI: 10.1097/01.ccm.0000906080.11377.60