Effects of prone position ventilation in neonatal respiratory distress syndrome:a meta-analysis / 中华护理杂志

ABSTRACT

Objective To systematically evaluate the effects of prone position ventilation on newborn with respiratory distress syndrome.Methods We searched databases including PubMed,EMBASE,Cochrane Library,Web of Science,CBM,CNKI,Wanfang and VIP.We included all randomized controlled trials and randomized crossover trials of neonatal respiratory distress syndrome.Studies were selected according to inclusion and exclusion criteria,extracting data and assessing quality.Then RevMan 5.3 software was used to analyze the data.Results Ten studies included seven randomized controlled trials and three randomized crossover trials,and 500 patients were included.The results of meta-analysis showed that in prone position ventilation group SaO2[MD=2.41,95％CI(0.87,3.95),P=0.002],PaO2[MD=5.20,95％CI(3.04,7.36),P＜0.001],Pa2//FiO2[MD=24.40,95％CI(8.35,40.44),P=0.003],the risk of pneumothorax [RR =0.10,95％ CI (0.01,0.76),P=0.03] and intracranial hemorrhage [RR =0.41,95％ CI (0.20,0.83),P=0.01]and duration of mechanical ventilation [MD=-23.22,95％CI(-38.30,-8.14),P=0.003] compared with supine positiongroup had significantly statistical difference;however there was no significant difference in ventilator-associated pneumonia[RR=0.72,95％CI(0.48,1.09),P=0.12] between two groups.Conclusion Prone position ventilation is effective to improve SaO2,PaO2 and PaO2/FiO2,shorten duration of mechanical ventilation and reduce the risk of pneumothorax and intracranial hemorrhage in newborn with respiratory distress syndrome.While it could not effectively reduce incidence of ventilator-associated pneumonia.Due to the limitations of the quality of studies included,multi-centered randomized controlled trials with large sample size are needed in the future to evaluate the effects of prone position ventilation on neonatal respiratory distress syndrome.