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All Journal Jurnal NERS Jurnal Aisyah : Jurnal Ilmu Kesehatan
Tan, Julianus Yudhistira
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Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Effectiveness of prone position with its moderating factors in non-intubated acute respiratory distress syndrome patients: a meta-analysis Tan, Julianus Yudhistira; Togatorop, Via Eliadora; Koerniawan, Dheni; Kosasih, Cecep Eli; Mediani, Henny Suzana
Jurnal Ners Vol. 19 No. 4 (2024): NOVEMBER 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jn.v19i4.60867

Abstract

Introduction: While numerous meta-analyses have explored the efficacy of awake prone position (APP), most have concentrated solely on intubation rate among Covid-19 patients without comprehensively identifying the influencing factors. This study aims to evaluate the efficacy of APP along with its moderating factors on oxygenation, intubation rate, and mortality in non-intubated acute respiratory distress syndrome (ARDS) patients. Methods: We conducted a systematic search in PubMed, Web of Science, and CINAHL from inception to December 2022. JBI critical appraisal tools were used to assess the study quality. Random-effects model was employed to calculate pooled standardized mean difference for continuous outcomes and risk ratio for dichotomous outcomes. Results: Among the 39 studies included, most patients were suffering from Covid-19, using conventional oxygen therapy, and receiving APP outside the ICU. APP significantly improved the PaO2/FiO2 ratio (SMD=0.70, 95% CI=0.51-0.88) and SpO2/FiO2 ratio (SMD=0.76, 95% CI=0.51-1.01), while also reducing the risk of intubation (RR=0.66, 95% CI=0.51-0.85) and mortality (RR=0.62, 95% CI=0.49-0.78). Factors including severity, respiratory device, body mass index, detail of position, use of medication assistance, total duration, follow-up time, position at follow-up, and study design significantly influence the effectiveness of APP. APP did not lead to significant improvements in length of stay and adverse events Conclusions: APP is a safe and beneficial intervention, enhancing oxygenation and reducing intubation and mortality rates in non-intubated ARDS patients. Importantly, various patient and intervention characteristics should be taken into account when implementing APP. Further well-designed experimental studies are needed to strengthen the evidence base.
Effectiveness of Awake Prone Position in Non-Intubated ARDS Patients: A Literature Review Tan, Julianus Yudhistira; Kosasih, Cecep Eli; Mediani, Henny Suzana
Jurnal Aisyah : Jurnal Ilmu Kesehatan Vol 9, No 1 (2024): March 2024
Publisher : Universitas Aisyah Pringsewu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30604/jika.v9i1.2664

Abstract

Background: The prone position is one of the highly recommended interventions to treat hypoxaemia and lung injury in ARDS patients. However, its efficacy in non-intubated patients remains inconclusive due to predominantly being reviewed through observational and case studies. This review aims to evaluate the efficacy of prone position on the oxygenation status and mortality rate of ARDS patients through experimental studies. Methode: This review systematically searched three international databases: PubMed, Web of Science, and CINAHL from November to December 2022, without restricting the publication year. The focus was solely on experimental studies examining the effectiveness of prone positioning in adult, non-intubated ARDS patients. The quality of studies was assessed using the JBI critical appraisal tool. Results: Of the 12 included studies, most RCTs were identified as poor quality. All patients appeared to be infected with Covid-19, and the majority were on conventional oxygen therapy. Most studies showed that the prone position was effective in improving the oxygenation status for up to two hours post-session, with a mortality rate not substantially different from that of control group. Further good-quality experimental studies are needed to strengthen these results. Conclusion: The prone position is quite effective in improving the oxygenation status of patients.
Co-Authors Cecep Eli Kosasih Dheni Koerniawan Henny Suzana Mediani Togatorop, Via Eliadora