Effectiveness of prone position in acute respiratory distress syndrome and moderating factors of obesity class and treatment durations for COVID-19 patients: A meta-analysis

Ashra, Fauzi; Chen, Ruey; Kang, Xiao Linda; Chiang, Kai-Jo; Pien, Li-Chung; Jen, Hsiu‐Ju; Liu, Doresses; Hsiao, Shu-Tai Shen; Chou, Kuei‐Ru

doi:10.1016/j.iccn.2022.103257

Cited by 10 publications

(7 citation statements)

References 61 publications

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“…Based on the diversity of anthropometric measurements and body ergonomics of proning mattress respondents in Table 1, the research team designed precise measurements of proning mattresses to increase patient comfort and accuracy in carrying out the pronation position, as shown in Figure 1. Several research results show evidence related to increasing oxygen saturation in patients with complaints of shortness of breath with COVID-19 after being given pronation position intervention (Ashra et al, 2022;Caputo et al, 2020;Elharrar et al, 2020), but there are several conditions identified related to the patient's inability to continue the pronation position (tolerating the position) include position discomfort, patient uncooperativeness, worsening oxygenation, desaturation, pain, and anxiety in the patient (Coppo et al, 2020;Winearls et al, 2020;Wormser et al, 2021). This discomfort is often associated with pillows that shift easily in manual proning techniques, so with this precision-sized mattress, it is hoped that patients will feel more comfortable without the fear of the pillow shifting.…”

Section: Resultsmentioning

confidence: 99%

Design of a Proning Mattress to Increase Oxygen Saturation in Patients with Respiratory Problems

Rosida,

Fitriahadi,

Ariyanto

et al. 2023

Kemas

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Posisi pronasi yang tepat terbukti dapat meningkatkan saturasi oksigen pada pasien dengan gangguan pernafasan, namun demikian masih muncul banyak kebingungan dikarenakan pengaturan posisi pronasi hanya dianjurkan dengan menggunakan penyangga bantal di beberapa titik tubuh pasien. Perbedaan ukuran bantal sangat dimungkinkan terjadi pada setiap pengaturan posisi di tempat yang berbeda, sehingga diperlukan alat pengatur posisi pronasi yang sudah presisi, aman, nyaman dan dapat langsung digunakan oleh pasien dengan keluhan sesak nafas. Tujuan dari penelitian ini adalah membuat dan mengembangkan prototipe “marning” (matras proning) untuk mempermudah melakukan posisi pronasi dalam upaya meningkatkan saturasi Oksigen pada pasien dengan keluhan sesak nafas. Metode penelitian dilakukan dengan membuat Matras proning yang didesain dengan mempertimbangkan bentuk anatomi dan ergonomi tubuh, sehingga sudah sangat presisi dalam meningkatkan saturasi oksigen. Uji presisi dan ergonomi tubuh untuk pembuatan dan penentuan ukuran matras dilakukan melalui pengukuran terhadap 20 responden dengan berbagai macam postur baik laki laki maupun perempuan. Pengukuran dilakukan di laboratorium klinik fisioterapi. Setelah itu hasil prototipe matras diuji efektifitasnya pada pasien sesak nafas untuk melihat peningkatan saturasi oksigen sebelum dan sesudah menggunakan matras proning. Uji efektifitas dilakukan di Poli Infeksi Puskesmas pathuk 1 Gunungkidul Yogyakarta sebagai mitra pada penelitian ini. Model teknologi ini sudah berhasil dibuat prototipenya dan telah diujicobakan pada 8 responden dengan keluhan sesak nafas, hasilnya terjadi peningkatan saturasi oksigen pada 80% pasien dengan keluhan sesak nafas (saturasi dibawah 95%). Matras ini didesain untuk menggantikan penggunaan bantal pada pengaturan posisi proning yang umum. Desain marning yang mempertimbangkan bentuk anatomi dan ergonomi tubuh menghasilkan ukuran yang presisi sehingga mencegah bantal bergeser. Inovasi ini memungkinkan pasien melakukan posisi proning yang tepat, nyaman dan juga sangat efektif dan efisien karena dapat langsung digunakan secara mandiri, namun demikian alat yang dikembangkan perlu penyempurnaan pada riset berikutnya, untuk mendapatkan alat yang lebih ringan sehingga mudah untuk dipindahkan dan dibawa kemana saja.

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Section: Resultsmentioning

confidence: 99%

Design of a Proning Mattress to Increase Oxygen Saturation in Patients with Respiratory Problems

Rosida,

Fitriahadi,

Ariyanto

et al. 2023

Kemas

View full text Add to dashboard Cite

show abstract

“…Breathing exercises have proven to significantly alleviate respiratory distress and improve lung function parameters (Vital Capacity, Total Lung Capacity, Forced Expiratory Volume in 1 s, Partial Pressure of Oxygen), as confirmed by systematic reviews. [166][167][168] Moreover, improvements in respiratory function have been linked to increased strength in lower limb muscles and enhanced functional capacity, 169 emphasizing the role of comprehensive rehabilitation programs that incorporate breathing exercises to meet the specific needs of patients.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Rehabilitation Interventions in Individuals With Emerging Virtual Respiratory Tract Infectious Disease: A Systematic Review and Meta-Analysis

Huang,

Qiao,

Song

et al. 2024

Clin Rehabil

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Objective Assessing rehabilitation effectiveness for persistent symptoms post-infection with emerging viral respiratory diseases. Data sources Systematic review of seven databases (MEDLINE, EMBASE, Cochrane Library, PEDro, MedRxiv, CNKI, Wanfang) until 30 December 2023. Review methods Evaluated 101 studies (9593 participants) on respiratory function, exercise capacity, and quality of life. Methodological quality was assessed using the Cochrane Collaboration's Risk of Bias tool for randomized controlled trials (RCTs), the Newcastle-Ottawa Scale (NOS) for observational studies and non-RCTs, and the NIH Quality Assessment Tools for before-after studies. Results The most common rehabilitation program combined breathing exercises with aerobic exercise or strength training. Rehabilitation interventions significantly enhanced respiratory function, as evidenced by improvements on the Borg Scale (MD, −1.85; 95% CI, −3.00 to −0.70, low certainty), the mMRC Dyspnea Scale (MD, −0.45; 95% CI, −0.72 to −0.18, low certainty), and the Multidimensional Dyspnoea-12 Scale (MD, −4.64; 95% CI, −6.54 to −2.74, moderate certainty). Exercise capacity also improved, demonstrated by results from the Six-Minute Walk Test (MD, 38.18; 95% CI, 25.33–51.03, moderate certainty) and the Sit-to-Stand Test (MD, 3.04; 95% CI, 1.07–5.01, low certainty). Conclusion Rehabilitation interventions are promising for survivors of viral respiratory diseases, yet gaps in research remain. Future investigations should focus on personalizing rehabilitation efforts, utilizing remote technology-assisted programs, improving research quality, and identifying specific subgroups for customized rehabilitation strategies to achieve the best outcomes for survivors.

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“…This adds to prior reports of a decrease in the mortality among hospitalized persons between COVID-19 waves ( 33 , 34 ), but our results indicate that this is especially pronounced in diabetes. The increased use of corticosteroids ( 35 ), prone positioning ( 36 ) and anti-viral treatment ( 37 ) during the pandemic could have had an impact on the risk of mortality in hospitalized persons. As the risk of severe COVID-19 infection is higher in persons with diabetes, a higher impact of advances in the treatment of severe COVID-19 would concomitantly be expected in persons with diabetes.…”

Section: Discussionmentioning

confidence: 99%

Risk of severe COVID-19 infection in persons with diabetes during the first and second waves in Denmark: A nationwide cohort study

et al. 2022

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ObjectiveCoronavirus disease-2019 (COVID-19) increases risk of hospitalization and death in diabetes and diabetes-related conditions. We examined the temporal trends in COVID-19-related hospitalization and mortality in the total Danish population by diabetes and diabetes-related conditions in the two first waves of COVID-19 in Denmark.Materials and methodsWe identified all persons with diabetes in the whole Danish population using national registries. COVID-19-related risks of hospitalization and death were assessed using Cox regression analysis in wave 1 (1 March-31 August 2020) and wave 2 (1 September 2020-28 February 2021) of the pandemic for persons with (n=321,933) and without diabetes (n=5,479,755). Analyses were stratified according to status of hypertension, obesity, cardiovascular and microvascular disease.ResultsThe cumulative incidence of COVID-19 hospitalization increased from wave 1 to wave 2 in both persons without (from 4 to 10 in 10,000) and with diabetes (from 16 to 54 per 10,000). The relative risk of hospitalization, however, increased more in patients with diabetes compared to persons without (age-, sex- and co-morbidity-adjusted HR [aHR] 1.40 (95% CI 1.27, 1.55) versus 1.76 (1.65, 1.87), p<0.001 for interaction with wave). The mortality rate, according to the whole population, increased similarly in persons without and with diabetes from wave 1 to wave 2 (from 0.63 to 1.5 versus from 4.3 to 10 in 10,000; aHR 1.65; 1.34, 2.03 and 1.64; 1.43, 1.88). However, when mortality was restricted to the hospitalized population, the crude mortality fell from 26.8% to 19.6% in persons with diabetes, while only a minor decrease was seen in persons without diabetes (from 16.7% to 15.5%).ConclusionThe risk of COVID-19-related hospitalization increased more in persons with than without diabetes from wave 1 to wave 2 of the COVID-19 pandemic in the Danish population. However, mortality according to the whole population did not change, due to reduced mortality among hospitalized persons with diabetes.

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Effectiveness of prone position in acute respiratory distress syndrome and moderating factors of obesity class and treatment durations for COVID-19 patients: A meta-analysis

Cited by 10 publications

References 61 publications

Design of a Proning Mattress to Increase Oxygen Saturation in Patients with Respiratory Problems

Design of a Proning Mattress to Increase Oxygen Saturation in Patients with Respiratory Problems

Effectiveness of Rehabilitation Interventions in Individuals With Emerging Virtual Respiratory Tract Infectious Disease: A Systematic Review and Meta-Analysis

Risk of severe COVID-19 infection in persons with diabetes during the first and second waves in Denmark: A nationwide cohort study

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