Semi-recumbent position reduces the risk of clinically suspected VAP in patients on mechanical ventilation, compared to a supine position

Added March 24, 2020

Citation: Wang L, Li X, Yang Z, et al. Semi-recumbent position versus supine position for the prevention of ventilator-associated pneumonia in adults requiring mechanical ventilation. Cochrane Database of Systematic Reviews 2016; (1): CD009946 

What is this? Some patients with COVID-19 will develop respiratory failure and need help with their breathing. This might be provided by mechanical ventilation (MV) in an intensive care unit (ICU), but this can cause complications, including ventilator-associated pneumonia (VAP). A semi-recumbent position (also known as “head bed elevation”) may prevent VAP in comparison to a supine position.

In this Cochrane systematic review, the authors included randomized trials that compared semi-recumbent versus supine positioning, or alternative degrees of positioning, in patients on MV.  They did not restrict by date, type or language of publication and did their searches in October 2015. They identified 10 trials (878 participants).

What works: A semi-recumbent position (30-60 degrees) reduces the risk of clinically suspected VAP in patients on MV, when compared to a supine position (0-10 degrees).

What doesn’t work: Nothing noted.

What’s uncertain: The comparative effects of the different positions are uncertain for outcomes other than clinically suspected VAP.

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.

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