A Meta-analysis: Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia (Sud S, et al. Intensive Care Med, 2010; 36: 585-599)

Objective 

 

  • To determine effects of prone versus supine ventilation in AHRF (acute hypoxemic respiratory failure) and severe hypoxemia [partial pressure of arterial oxygen (PaO(2))/inspired fraction of oxygen (FiO(2)) <100 mmHg] compared with moderate hypoxemia (100 mmHg </= PaO(2)/FiO(2) </= 300 mmHg).

Methods 

 

  • Systematic review and meta-analysis.
  • Electronic databases (to Nov 2009) and conference proceedings searched.
  • Ten trials (N = 1,867 patients) met inclusion criteria; most patients had acute lung injury.

Results

  • Post hoc analysis demonstrated statistically significant improved mortality in the more hypoxemic subgroup and significant differences between subgroups using a range of PaO2/FiO2 thresholds up to approximately 140 mmHg.