Meta analysis of observing prone position ventilation role in the oxygenation of severe pneumonia patients / 中华危重病急救医学

ABSTRACT

Objective To systematically evaluate the clinical effect of prone position mechanical ventilation on the improvement of oxygenation in patients with severe pneumonia. Methods Pubmed, Embase, Cochrane Library, CNKI, Wanfang Data and VIP database were searched from the time of database built up until December 10th, 2017. All the published randomized controlled trials (RCTs) about the effects of prone position ventilation on the oxygenation of severe pneumonia patients were screened, and were confirmed by the literature reference citation retrieval. Inclusion and exclusion criteria had been used to review and rank the literature. After evaluating the quality of included studies, the data was extracted from RCTs and given a Meta-analysis using RevMen 5.1. Results Twelve RCTs with 650 cases were included. Eleven of them were Chinese literature while 1 was in English. Ten studies showed that the prone position ventilation had a significant influence on improving partial pressure of oxygen [weighted mean difference (WMD) =9.93, 95% confidence interval (95%CI) = 2.92-16.95, P = 0.006], publication bias was found in these studies. Seven studies showed that the prone position ventilation had a significant influence on partial pressure of carbon dioxide (WMD =9.99, 95%CI = 1.81-18.18, P = 0.02), publication bias was found in these studies. Seven studies showed that the prone position ventilation had a significant influence on oxygenation index (WMD = 31.22, 95%CI = 26.06-36.39, P < 0.000 01), publication bias was found in these studies. Two studies showed that the prone position ventilation had a significant influence on oxygen saturation of blood (WMD = 2.12, 95%CI = 1.24-3.00, P < 0.000 01), no publication bias was found in these studies. Conclusion Prone position ventilation can effectively improve the patients' oxygenation index, partial pressure of oxygen, and oxygen saturation of blood, and reduce the partial pressure of carbon dioxide.