COVID-19 患者的俯卧位通气：多中心登记数据分析和汇总数据的荟萃分析。
Prone Positioning in Patients With COVID-19: Analysis of Multicenter Registry Data and Meta-analysis of Aggregate Data.
机构信息
Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece
Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece.
出版信息
In Vivo. 2022 Jan-Feb;36(1):361-370. doi: 10.21873/invivo.12711.
BACKGROUND/AIM: Evidence suggests a beneficial effect of prone positioning (PP) in COVID-19.
MATERIALS AND METHODS
Meta-analysis of individual (7 investigators' groups) and aggregate data (PubMed/EMBASE) regarding the impact of PP on the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PO/FiO) in patients with COVID-19.
RESULTS
Among 121 patients (mean age±SD 59.1±10.7 years, 55% males, 57% intubated) the mean post-versus pre- PP PO/FiO difference was: (i) 50.4±64.3 mmHg, p<0.01, (ii) similar in awake (58.7±72.1 mmHg) versus intubated patients (44.1±57.5 mmHg, p=NS), (iii) inversely correlated with body mass index (r=-0.43, p<0.01). Meta-analysis of 23 studies (n=547, weighted age 58.3±4.1, 73% males, 59% intubated) showed a pooled PO/FiO difference of 61.8 [95% confidence intervals=49.9-73.6] mmHg. Meta-regression analysis revealed no associations with baseline demographics, the time in PP before assessment, and the risk of bias of the studies.
CONCLUSION
PP seems to improve oxygenation of patients with COVID-19.
背景/目的：有证据表明俯卧位（PP）对 COVID-19 有益。
材料和方法
对关于 PP 对 COVID-19 患者动脉血氧分压与吸入氧分数比值（PO/FiO）影响的个体（7 个研究小组）和汇总数据（PubMed/EMBASE）进行荟萃分析。
结果
在 121 名患者（平均年龄±标准差 59.1±10.7 岁，55%为男性，57%为插管患者）中，PP 后与 PP 前 PO/FiO 差值为：（i）50.4±64.3mmHg，p<0.01，（ii）清醒（58.7±72.1mmHg）与插管患者（44.1±57.5mmHg，p=NS）相似，（iii）与体重指数呈负相关（r=-0.43，p<0.01）。对 23 项研究（n=547，加权年龄 58.3±4.1，73%为男性，59%为插管患者）的荟萃分析显示，PO/FiO 差值为 61.8[95%置信区间=49.9-73.6]mmHg。元回归分析显示，与基线人口统计学特征、评估前 PP 时间以及研究的偏倚风险均无关联。
结论
PP 似乎可改善 COVID-19 患者的氧合。
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