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Effect of prone versus supine position in COVID-19 patients: A systematic review and meta-analysis

Chua EX 1 , Zahir SMISM 1 , Ng KT 2 , Teoh WY 3 , Hasan MS 1 , Ruslan SRB 1 Show all authors , Abosamak MF 4

Affiliations 

  • 1 Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur, Malaysia
  • 2 Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur, Malaysia. Electronic address: [email protected]
  • 3 Faculty of Medicine, University of Liverpool, Liverpool L69 3BX, United Kingdom
  • 4 Department of Anaesthesia and Intensive care medicine, Faculty of medicine, Tanta University, Egypt
J Clin Anesth, 2021 Nov;74:110406.
PMID: 34182261 DOI: 10.1016/j.jclinane.2021.110406

Abstract

STUDY OBJECTIVE: To review the effects of prone position and supine position on oxygenation parameters in patients with Coronavirus Disease 2019 (COVID-19).

DESIGN: Systematic review and meta-analysis of non-randomized trials.

PATIENTS: Databases of EMBASE, MEDLINE and CENTRAL were systematically searched from its inception until March 2021.

INTERVENTIONS: COVID-19 patients being positioned in the prone position either whilst awake or mechanically ventilated.

MEASUREMENTS: Primary outcomes were oxygenation parameters (PaO₂/FiO₂ ratio, PaCO₂, SpO₂). Secondary outcomes included the rate of intubation and mortality rate.

RESULTS: Thirty-five studies (n = 1712 patients) were included in this review. In comparison to the supine group, prone position significantly improved the PaO₂/FiO₂ ratio (study = 13, patients = 1002, Mean difference, MD 52.15, 95% CI 37.08 to 67.22; p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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