Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis

Aeen, Fatemeh Behesht; Pakzad, Reza; Rad, Mohammad Goudarzi; Abdi, Fatemeh; Zaheri, Farzaneh; Mirzadeh, Narges

doi:10.1038/s41598-021-93739-y

Cited by 32 publications

(20 citation statements)

References 49 publications

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“…"Metaprop" commands were applied in a forest plot to estimate the pooled prevalence with a 95% confidence interval (CI). A random-effects model was used to estimate the pooled prevalence [15][16][17][18][19][20]. Meta-regression analysis was used to evaluate the effect of the WHO region, sample size, and age on heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

Worldwide prevalence of fungal coinfections among COVID-19 patients: a comprehensive systematic review and meta-analysis

Soltani

Zandi

Faramarzi

et al. 2022

PHRP

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Microbial coinfections can increase the morbidity and mortality rates of viral respiratory diseases. Therefore, this study aimed to determine the pooled prevalence of fungal coinfections in coronavirus disease 2019 (COVID-19) patients. Web of Science, Medline, Scopus, and Embase were searched without language restrictions to identify the related research on COVID-19 patients with fungal coinfections from December 1, 2019, to December 30, 2020. A random-effects model was used for analysis. The sample size included 2,246 patients from 8 studies. The pooled prevalence of fungal coinfections was 12.60%. The frequency of fungal subtype coinfections was 3.71% for Aspergillus, 2.39% for Candida, and 0.39% for other. The World Health Organization's Regional Office for Europe and Regional Office for Southeast Asia had the highest (23.28%) and lowest (4.53%) estimated prevalence of fungal coinfection, respectively. Our findings showed a high prevalence of fungal coinfections in COVID-19 cases, which is a likely contributor to mortality in COVID-19 patients. Early identification of fungal pathogens in the laboratory for COVID-19 patients can lead to timely treatment and prevention of further damage by this hidden infection.

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Section: Discussionmentioning

confidence: 99%

Worldwide prevalence of fungal coinfections among COVID-19 patients: a comprehensive systematic review and meta-analysis

Soltani

Zandi

Faramarzi

et al. 2022

PHRP

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“…Our results were comparable to the previous researches. [18,19] We found that 55 (64.7%) patients had moderate disease while 30 (35.3%) had severity of disease among all cases. [18] Symptoms such as fever, cough, and dyspnea were the most often reported in both groups.…”

Section: Discussionmentioning

confidence: 69%

Effectiveness of Prone Position among Patients with Acute Respiratory Disease (COVID-19)

Abdullah¹,

Khan²,

Babur³

2022

PJMHS

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Objective: Aim of current study is to determine the effectiveness of prone position in patients presented with severe coronavirus disease. Study Design: Observational /Retrospective study Place and Duration: King Salman Armed Forces Hospital Tabuk KSA. Feb 2021-Dec 2021 Methods: This research comprised a total of 85 patients with respiratory failure who were admitted to the ICU. Patients ranged in age from 20 to 75. After obtaining written permission from each patient, demographic information such as age, gender, and BMI was collected. A and B were the two groups of patients that were studied. Group A included 40 patients with COVID-19 who completed prone position testing, whereas group II included 45 patients as a comparison group. During the 15-day follow up period, patients in group A were remained in a prone posture whereas those in group B were subjected to invasive ventilation. Outcomes among both groups were compared in terms of mortality, hospital stay and reduction in intubation rate. Analyzation of data was completed by using SPSS 24.0 version. Results: The majority of the patients were men, with 60 (70.6%) of the total, while the others were females, with 25 (29.4%). The mean age of the patients in the prone posture group was 48.12 years, with a mean BMI of 27.5 kg/m2, whereas the mean age of the patients in the control group was 50.4 years, with a mean BMI of 27.9 kg/m2. The average time spent in the prone position was 6.08 hours. When comparing the prone group to the controlled group, the mean PF ratio was higher in the former. The average length of stay in group A was 7.2 days, whereas the average length of stay in group B was 10.5 days. Group A had a death rate of 2 (5%), while group B had a mortality rate of 5 (11.1%). Conclusion: As a result of this research, we came to the conclusion that the prone position was an effective and safe approach for reducing intubation, mortality, and hospital stay in patients of COVID-19. After this procedure, no side effects were observed. Keywords: Respiratory Failure, Mortality, Prone Position, Covid-19,

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“…64 It has also been shown to improve oxygenation and reduce mortality and intubation rates for patients with severe novel coronavirus disease 2019 (COVID-19). 64,65 Lung secretion movement has been shown to be influenced by gravitational forces during invasive MV in laboratory studies, 39,66 but scientific evidence separately assessing the efficacy of patient positioning alone (e.g., postural drainage) to clear secretions in critically ill patients is weak. 67 However, several studies assessing other respiratory physiotherapy techniques (e.g., hyperinflations) combined with patient positioning (i.e., side-lying or head-down tilt) have reported positive results in terms of secretion clearance 36,68 or VAP.…”

Section: Mechanism Of Action Proposed Physiological Principlementioning

confidence: 99%

“…64 It has also been shown to improve oxygenation and reduce mortality and intubation rates for patients with severe novel coronavirus disease 2019 (COVID-19). 64 65…”

Section: Treatmentmentioning

confidence: 99%

An Update on Cardiorespiratory Physiotherapy during Mechanical Ventilation

Tronstad

Martí

Ntoumenopoulos

et al. 2022

Semin Respir Crit Care Med

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Physiotherapists are integral members of the multidisciplinary team managing critically ill adult patients. However, the scope and role of physiotherapists vary widely internationally, with physiotherapists in some countries moving away from providing early and proactive respiratory care in the intensive care unit (ICU) and focusing more on early mobilization and rehabilitation. This article provides an update of cardiorespiratory physiotherapy for patients receiving mechanical ventilation in ICU. Common and some more novel assessment tools and treatment options are described, along with the mechanisms of action of the treatment options and the evidence and physiology underpinning them. The aim is not only to summarize the current state of cardiorespiratory physiotherapy but also to provide information that will also hopefully help support clinicians to deliver personalized and optimal patient care, based on the patient's unique needs and guided by accurate interpretation of assessment findings and the current evidence. Cardiorespiratory physiotherapy plays an essential role in optimizing secretion clearance, gas exchange, lung recruitment, and aiding with weaning from mechanical ventilation in ICU. The physiotherapists' skill set and scope is likely to be further optimized and utilized in the future as the evidence base continues to grow and they get more and more integrated into the ICU multidisciplinary team, leading to improved short- and long-term patient outcomes.

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Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis

Cited by 32 publications

References 49 publications

Worldwide prevalence of fungal coinfections among COVID-19 patients: a comprehensive systematic review and meta-analysis

Worldwide prevalence of fungal coinfections among COVID-19 patients: a comprehensive systematic review and meta-analysis

Effectiveness of Prone Position among Patients with Acute Respiratory Disease (COVID-19)

An Update on Cardiorespiratory Physiotherapy during Mechanical Ventilation

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