Meta Analysis of the Influence of Prone Ventilation Duration on the Mortality of Acute Respiratory Distress Syndrome at 28 Days and 3 Months
Introduction: To evaluate the effect of prone ventilation duration on the mortality of patients with acute respiratory distress syndrome (ARDS) at 28 days and 3 months.Materials and Methods: Use a computer to search of relevant studies published in PubMed, the Cochrane Library, CBM, CnKI, VIP and Wanfang database on the influence of prone ventilation on the mortality rate of ARDS patients was conducted. Two personnel trained in evidence-based medicine collected literature and extracted data
... extracted data against inclusion and exclusion criteria, and Meta analysis was conducted using RevMan 5.3 software. A total of 29 randomized controlled trials were included, involving 3,617 patients. These studies were divided into the <8 hour group, the 8-16 hour group, and the >=16 hour group according to according to the duration of prone ventilation.Results: The total effect value of 28d fatality rate was [(OR=0.58, 95%CI(0.46, 0.73), P<0.00001]. All subgroups and the combined effect were statistically significant. Among the 3M fatality rates, only>= 16-hour prone ventilation was statistically significant, and the effect value was [(OR=0.59, 95%CI (0.46, 0.75), P<0.0001]. The 3M fatality rates of the 8-16 hour and <8 hour groups were not statistically significant. Since there was only one study on 8-16 hour ventilation, only subgroup analysis was performed without combining the statistical values of the three groups.Conclusion: Prone ventilation can reduce the short-term mortality of ARDS patients, but from a long time (>=3M), only prone ventilation time >=16 hours can significantly benefit patients. The registration number will be issued.