Cochrane · systematic review · CD009946
Semi‐recumbent position versus supine position for the prevention of ventilator‐associated pneumonia in adults requiring mechanical ventilation
Wang, L, Li, X, Yang, Z, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Acute Respiratory InfectionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
12
current version
GRADE rated
12
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 7 · 58.3%Low 3 · 25%Moderate 2 · 16.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Semi‐recumbent position (30º to 60º) versus supine position (0° to 10°) for the prevention of ventilator‐associated pneumonia in adults requiring mechanical ventilation
Population: adults requiring mechanical ventilation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinically suspected VAP Semi‐recumbent position (30º to 60º) vs supine position (0° to 10°) | RR 0.36 [0.25, 0.5] | 8 studies · 759 participants | Moderate Downgraded: risk of bias |
Microbiologically confirmed VAP Semi‐recumbent position (30º to 60º) vs supine position (0° to 10°) | RR 0.44 [0.11, 1.77] | 3 studies · 419 participants | Very low Downgraded: inconsistency, publication bias |
ICU mortality Semi‐recumbent position (30º to 60º) vs supine position (0° to 10°) | RR 0.87 [0.59, 1.27] | 2 studies · 307 participants | Low Downgraded: publication bias |
Hospital mortality Semi‐recumbent position (30º to 60º) vs supine position (0° to 10°) | RR 0.84 [0.59, 1.2] | 3 studies · 346 participants | Low Downgraded: publication bias |
Length of ICU stay Semi‐recumbent position (30º to 60º) vs supine position (0° to 10°) | no estimate extracted | 3 studies · 346 participants | Moderate |
Length of hospital stay Semi‐recumbent position (30º to 60º) vs supine position (0° to 10°) | no estimate extracted | 2 studies · 260 participants | Very low Downgraded: inconsistency, publication bias |
Pressure ulcers Semi‐recumbent position (30º to 60º) vs supine position (0° to 10°) | RR 0.91 [0.6, 1.38] | 1 study · 221 participants | Low Downgraded: publication bias |
Semi‐recumbent positioning: 45° versus 25° to 30° for the prevention of ventilator‐associated pneumonia in adults requiring mechanical ventilation
Population: adults requiring mechanical ventilation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinically suspected VAP Semi‐recumbent positioning: 45° vs 25° to 30° | RR 0.74 [0.35, 1.56] | 2 studies · 91 participants | Very low Downgraded: risk of bias, imprecision |
Microbiologically confirmed VAP Semi‐recumbent positioning: 45° vs 25° to 30° | RR 0.61 [0.2, 1.84] | 1 study · 30 participants | Very low Downgraded: risk of bias |
ICU mortality Semi‐recumbent positioning: 45° vs 25° to 30° | OR 0.57 [0.15, 2.13] | 1 study · 30 participants | Very low Downgraded: risk of bias |
Hospital mortality Semi‐recumbent positioning: 45° vs 25° to 30° | OR 1 [0.38, 2.65] | 2 studies · 91 participants | Very low Downgraded: risk of bias, imprecision |
Length of ICU stay Semi‐recumbent positioning: 45° vs 25° to 30° | MD 1.6 | 1 study · 61 participants | Very low Downgraded: risk of bias |