Longer prone positioning has uncertain effects on survival in ARDS
A review found no statistically significant mortality difference between prolonged and shorter prone sessions, with evidence too uncertain to rule out benefit or harm.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
The pooled evidence did not show a statistically clear survival advantage for longer prone sessions in adults with ARDS. Oxygenation and safety outcomes also showed no significant differences. Because the evidence was uncertain and imprecise, these findings should not be read as proof that the approaches are equivalent or that longer sessions are harmless.
Evidence certainty was low to very low, with imprecision and inconsistency limiting conclusions. This abstract-based account reflects mostly COVID-19 ARDS studies, which limits how broadly the findings can be applied.
What researchers found
Hazard ratio for 90-day mortality
Prone sessions ≥24 hours versus <24 hours; the interval allows both lower and higher mortality hazards.
What was being compared
The review compared how long adults with ARDS remained positioned face down. It combined randomized trials with observational studies, so the quality and design of the contributing studies matter when interpreting the pooled result.
Why uncertainty remains
The confidence interval spans possible benefit and harm. The absence of a statistically significant difference therefore leaves a clinical question unresolved, rather than demonstrating equal survival or safety between the approaches.
The original publication
Effectiveness and safety of prolonged prone positioning in adult patients with acute respiratory distress syndrome (ARDS): a systematic review and meta-analysis.
Jung C, Gillmann HJ, Stueber T
Crit Care · 2025
- PubMed ID
- 41199320
- Record checked
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