Department of Physical Medicine, Charité - Universitätsmedizin Berlin, Free University of Berlin, Berlin, Germany -
Humboldt University of Berlin, Berlin, Germany -
Eur J Phys Rehabil Med. 2023 Feb;59(1):111-121. doi: 10.23736/S1973-9087.22.07529-3. Epub 2022 Nov 28.
Prone positioning ventilation (PPV) is an effective treatment for patients with moderate to severe acute respiratory distress syndrome (ARDS). Despite the benefits of PPV, different kinds of short and long-term consequences have been noted. This review summarizes long-term complications of PPV that impact treatment strategies and outcomes in acute and postacute rehabilitation.
PubMed/Medline, Cochrane Library, Cochrane COVID-19 Study Register databases and the Google Scholar search engine were systematically searched for studies investigating long-term complications of PPV. The final search date for all sources/databases was January 31, 2022. For our methodological appraisal, we conducted a systematic review of articles without any restrictions on types of articles or publication dates. Only articles published in English and available as full texts were eligible for inclusion. After the screening process, data of interest were extracted from eligible sources: PPV sequelae and conclusions (i.e. possible effects on the course of rehabilitation and therapy strategies).
A total of 59 studies are included in this review. Long-term consequences are mainly pressure ulcers and nerve lesions that exist after discharge from the Intensive Care Unit (ICU). Publications rarely recommend treatment strategies for long-term complications after PPV. Due to the quality of the included studies, no robust conclusions as to effective strategies can be drawn.
Further high-quality research is required, considering the different long-term complications after PPV and their impact on rehabilitation in order to draw conclusions about viable physical therapies. Crucially, however, prone positioning (PP) sequelae pose new challenges to physicians and therapists in acute and postacute rehabilitation medicine as well as follow-up care.
俯卧位通气（PPV）是治疗中重度急性呼吸窘迫综合征（ARDS）患者的有效方法。尽管 PPV 有很多益处，但也有许多短期和长期的后果。本综述总结了影响急性和康复后治疗策略和结果的 PPV 的长期并发症。
通过系统检索 PubMed/Medline、Cochrane 图书馆、Cochrane COVID-19 研究注册数据库和 Google Scholar 搜索引擎，以寻找研究 PPV 长期并发症的研究。所有来源/数据库的最终搜索日期为 2022 年 1 月 31 日。对于我们的方法学评估，我们对没有任何文章类型或出版日期限制的文章进行了系统综述。只有发表在英语且可提供全文的文章才有资格被纳入。经过筛选过程，从合格的来源中提取出感兴趣的数据：PPV 后遗症和结论（即对康复过程和治疗策略的可能影响）。
本综述共纳入 59 项研究。长期后果主要是压力性溃疡和神经损伤，这些损伤在从重症监护病房（ICU）出院后存在。出版物很少推荐 PPV 后长期并发症的治疗策略。由于纳入研究的质量，对于有效的策略，无法得出可靠的结论。
需要进一步开展高质量的研究，考虑到 PPV 后的不同长期并发症及其对康复的影响，以便得出可行的物理治疗结论。然而，至关重要的是，俯卧位（PP）后遗症给急性和康复后医学以及后续护理的医生和治疗师带来了新的挑战。
