Definition and prognostic value of response to prone positioning in ARDS: a systematic review and meta-analysis - PubMed
2 days ago
- #Meta-analysis
- #ARDS
- #Prone Positioning
- This systematic review and meta-analysis investigated definitions and prognostic value of response to prone positioning in ARDS. It identified high heterogeneity in definitions of response.
- Oxygenation change (PaO2/FiO2) was the most common definition (53 studies), with a pooled proportion of 68% of patients being responders.
- Alternative definitions using other physiological variables (e.g., CO2 clearance, respiratory mechanics) showed lower pooled responder proportions, ranging from 45% to 53%.
- Among studies reporting mortality, 42% found a reduced risk of death in responders. A sensitivity analysis of five studies at serious risk of bias also showed lower mortality in responders.
- High risk of bias, residual confounding, and significant study heterogeneity limit robust conclusions on the association between physiological response to prone positioning and survival.