RESUMO
Objective: To systematically assess the impact of prone position ventilation on hypoxemia in patients following extracorporeal cardiac surgery and to establish a reference for further clinical investigation into effective post-surgery mechanical ventilation positions. Methods: A meta-analysis was conducted through extensive database searches, focusing on randomized controlled trials of cardiopulmonary bypass in hypoxic patients meeting specific inclusion and exclusion criteria. A total of 8 papers involving 442 patients were finally included in this study. Results: The meta-analysis revealed that the oxygenation index was significantly higher in the prone position ventilation group compared to the supine position ventilation group [MD=51.24, 95% CI (46.14, 56.35), P < .001]. The partial pressure of oxygen in prone patients was also significantly higher than in supine patients [MD=-2.96, 95% CI (1.78, 4.14), P < .001]. Regarding oxygen saturation, blood oxygen saturation in the prone position group surpassed that in the supine position group, showing a statistically significant difference [MD=4.81, 95% CI (3.83, 5.79), P < .001]. Additionally, patients ventilated in the prone position exhibited a shorter duration of mechanical ventilation compared to those in the supine position, with a statistically significant difference [MD=-57.31, 95% CI (-66.57, -48.06), P < .001]. Conclusions: In the absence of significant hemodynamic changes, prone position ventilation significantly enhances the oxygenation index and reduces the duration of mechanical ventilation in patients undergoing extracorporeal circulation surgery. However, the observed heterogeneity across studies may be attributed to variations in breathing styles, respiratory techniques, and physiological parameters among different patient groups.