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The efficacy and safety of prone positioning in adults patients with acute respiratory distress syndrome: a meta-analysis of randomized controlled trials

DC Field Value Language
dc.contributor.author변민광-
dc.contributor.author정지예-
dc.date.accessioned2016-02-04T11:14:04Z-
dc.date.available2016-02-04T11:14:04Z-
dc.date.issued2015-
dc.identifier.issn2072-1439-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/139965-
dc.description.abstractBACKGROUND: Prone positioning for acute respiratory distress syndrome (ARDS) has no impact on mortality despite significant improvements in oxygenation. However, a recent trial demonstrated reduced mortality rates in the prone position for severe ARDS. We evaluated effects of prone position duration and protective lung strategies on mortality rates in ARDS. METHODS: We extensively searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials (RCTs) reporting on prone positioning during acute respiratory failure in adults for inclusion in our meta-analysis. RESULTS: Eight trials met our inclusion criteria, Totals of 1,099 and 1,042 patients were randomized to the prone and supine ventilation positions. The mortality rates associated with the prone and supine positions were 41% and 47% [risk ratio (RR), 0.90; 95% confidence interval (CI), 0.82-0.98, P=0.02], but the heterogeneity was moderate (P=0.01, I(2)=61%). In a subgroup analysis, the mortality rates for lung protective ventilation (RR 0.73, 95% CI, 0.62-0.86, P=0.0002) and duration of prone positioning >12 h (RR 0.75, 95% CI, 0.65-0.87, P<0.0001) were reduced in the prone position. Prone positioning was not associated with an increased incidence of cardiac events (RR 1.01, 95% CI, 0.87-1.17) or ventilator associated pneumonia (RR 0.88, 95% CI, 0.71-1.09), but it was associated with an increased incidence of pressure sores (RR 1.23, 95% CI, 1.07-1.41) and endotracheal dislocation (RR 1.33, 95% CI, 1.02-1.74). CONCLUSIONS: Prone positioning tends to reduce the mortality rates in ARDS patients, especially when used in conjunction with a lung protective strategy and longer prone position durations. Prone positioning for ARDS patients should be prioritized over other invasive procedures because related life-threatening complications are rare. However, further additional randomized controlled design to study are required for confirm benefit of prone position in ARDS.-
dc.description.statementOfResponsibilityopen-
dc.format.extent356~367-
dc.relation.isPartOfJOURNAL OF THORACIC DISEASE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleThe efficacy and safety of prone positioning in adults patients with acute respiratory distress syndrome: a meta-analysis of randomized controlled trials-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorSo Young Park-
dc.contributor.googleauthorHyun Jung Kim-
dc.contributor.googleauthorKwan Ha Yoo-
dc.contributor.googleauthorYong Bum Park-
dc.contributor.googleauthorSeo Woo Kim-
dc.contributor.googleauthorSeok Jeong Lee-
dc.contributor.googleauthorEun Kyung Kim-
dc.contributor.googleauthorJung Hyun Kim-
dc.contributor.googleauthorYee Hyung Kim-
dc.contributor.googleauthorJi-yong Moon-
dc.contributor.googleauthorKyung Hoon Min-
dc.contributor.googleauthorSung Soo Park-
dc.contributor.googleauthorJinwoo Lee-
dc.contributor.googleauthorChang-Hoon Lee-
dc.contributor.googleauthorJinkyeong Park-
dc.contributor.googleauthorMin Kwang Byun-
dc.contributor.googleauthorSei Won Lee-
dc.contributor.googleauthorChinKook Rlee-
dc.contributor.googleauthorJi Ye Jung-
dc.contributor.googleauthorYun Su Sim-
dc.identifier.doi10.3978/j.issn.2072-1439.2014.12.49-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA01848-
dc.contributor.localIdA03735-
dc.relation.journalcodeJ01907-
dc.identifier.eissn2077-6624-
dc.identifier.pmid25922713-
dc.subject.keywordProne positioning-
dc.subject.keywordacute respiratory distress syndrome (ARDS)-
dc.subject.keywordmortality-
dc.contributor.alternativeNameByun, Min Kwang-
dc.contributor.alternativeNameJung, Ji Ye-
dc.contributor.affiliatedAuthorByun, Min Kwang-
dc.contributor.affiliatedAuthorJung, Ji Ye-
dc.rights.accessRightsfree-
dc.citation.volume7-
dc.citation.number3-
dc.citation.startPage356-
dc.citation.endPage367-
dc.identifier.bibliographicCitationJOURNAL OF THORACIC DISEASE, Vol.7(3) : 356-367, 2015-
dc.identifier.rimsid48997-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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