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Article ; Online: Early Mobilization Dose Reporting in Randomized Clinical Trials with Patients Who Were Mechanically Ventilated: A Scoping Review.

González-Seguel, Felipe / Letelier-Bernal, Renato

2024

Abstract: Objective: The aim of this scoping review was to investigate the mobilization dose reporting in the randomized clinical trials (RCTs) of patients receiving mechanical ventilation in the intensive care unit.: Methods: In this scoping review, RCTs ... ...

Abstract	Objective: The aim of this scoping review was to investigate the mobilization dose reporting in the randomized clinical trials (RCTs) of patients receiving mechanical ventilation in the intensive care unit. Methods: In this scoping review, RCTs published from inception to December 2022 were searched in relevant electronic databases. Trials that involved adults receiving mechanical ventilation (>48 hours) and any early mobilization modality were analyzed. Two independent authors screened, selected, and extracted data. The mobilization doses of the intervention groups (IG) and the comparator groups (CG) were assessed as the proportion of reported items/total applicable from the main items of the Consensus on Exercise Reporting Template (CERT). Results: Twenty-three RCTs comprising 2707 patients (1358 from IG and 1349 from CG) were included, involving studies on neuromuscular electrical stimulation (n = 7), progressive mobility (n = 6), leg cycling (n = 3), tilt table (n = 1), and multicomponent (n = 6) mobilization. The pooled reporting of CERT items was 68% (86% for IG and 50% for CG). The most reported CERT items were type of exercise (100%) and weekly frequency (100%) for IG, whereas the least reported were intensity (4%) and individualization (22%) for CG. Regardless of the group, individualization, progression, and intensity of mobilization were the least reported items. Eight IGs (35%) reported all CERT items, whereas no CGs reported all of them. Conclusions: Deficits in mobilization dose reporting of intensive care unit RCTs were identified, especially for exercise intensity in adults receiving mechanical ventilation. One-third of IG reported all exercise dosing items, whereas no CG reported all of them. Future studies should investigate the details of optimal dosage reporting, particularly for CG. Impact: The lack of dose reporting may partially explain the inconsistency in the meta-analysis results of early mobilization trials, thus limiting the interpretation for clinical practice in the intensive care unit.
Language	English
Publishing date	2024-03-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	415886-6
ISSN	1538-6724 ; 0031-9023
ISSN (online)	1538-6724
ISSN	0031-9023
DOI	10.1093/ptj/pzae048
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Article ; Online: Evaluación del funcionamiento físico en cuidados críticos: encuesta nacional en más de 90 centros chilenos durante la pandemia por COVID-19.

González-Seguel, Felipe / Cáceres-Parra, Camilo

Revista medica de Chile

2023 Volume 150, Issue 12, Page(s) 1565–1574

Abstract: Background: Physical functioning evaluation in intensive care units (ICUs) identifies rehabilitation requirements and response to interventions.: Aim: To identify the usage rate of physical functioning measurement instruments in ICUs during the COVID- ...

Title translation	Physical functioning assessment tools in critical care: a wide national survey in Chile during the COVID-19 pandemic.
Abstract	Background: Physical functioning evaluation in intensive care units (ICUs) identifies rehabilitation requirements and response to interventions. Aim: To identify the usage rate of physical functioning measurement instruments in ICUs during the COVID-19 pandemic in Chile. Material and methods: Lead physiotherapists representing different national ICUs were invited to answer a National online survey at the onset (T1) and at the first year of COVID-19 pandemic (T2). The usage rate (defined as "always"/"almost always"/"almost never"/"never") of instruments assessing muscle strength, muscle mass, mobility, and physical performance was surveyed. Also, the reasons for selecting these instruments were requested. Results: We received responses from 94 and 93 ICUs at T1 and T2, respectively, of 111 eligible ICUs (55% public). Compared with T2, the usage rate of instruments was lower at T1, and significant only for Medical Research Sum-Score (MRC-SS) (p = 0.04) and handgrip dynamometry (p = 0.05). Considering the answers "always", "almost always" and "almost never", between 89% and 91% of the ICUs reported the use of the MRC-SS; between 70% and 73% reported the use of the Functional Status Score for the Intensive Care Unit; between 5% and 35% of the ICUs reported the use of the rest of mobility scales; and between 44%-45% of ICUs reported that muscle ultrasound was "almost never" used. The main reasons reported for selecting instruments were quick use and clinimetric properties. Conclusions: The usage rate of muscle strength assessments was frequent, while the use of mobility and muscle mass instruments recommended by the literature was poorly reported, which was lower at the onset of the pandemic.
MeSH term(s)	Humans ; Pandemics ; Hand Strength ; Chile/epidemiology ; COVID-19 ; Critical Care ; Intensive Care Units
Language	Spanish
Publishing date	2023-10-25
Publishing country	Chile
Document type	English Abstract ; Journal Article
ZDB-ID	732136-3
ISSN	0717-6163 ; 0034-9887
ISSN (online)	0717-6163
ISSN	0034-9887
DOI	10.4067/s0034-98872022001201565
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Article ; Online: Daily compliance of the ABCDEF liberation bundle for patients in the intensive care unit: A retrospective descriptive study

Muñoz-Muñoz, Felipe / Leppe, Jaime / González-Seguel, Felipe / Castro-Ávila, Ana

Medwave

2024 Volume 24, Issue 4, Page(s) e2795

Abstract: Introduction: Implementing the ABCDEF bundle has demonstrated improved outcomes in patients with critical illness. This study aims to describe the daily compliance of the ABCDEF bundle in a Chilean intensive care unit.: Methods: Retrospective ... ...

Title translation	Cumplimiento diario del bundle ABCDEF de liberación de los pacientes de cuidados intensivos: estudio descriptivo retrospectivo.
Abstract	Introduction: Implementing the ABCDEF bundle has demonstrated improved outcomes in patients with critical illness. This study aims to describe the daily compliance of the ABCDEF bundle in a Chilean intensive care unit. Methods: Retrospective observational study of electronic clinical records of nursing, physiotherapy, and medical professionals who cared for patients over 18 years of age, admitted to an intensive care unit for at least 24 hours, with or without mechanical ventilation. Daily bundle compliance was determined by considering the daily records for each element: Assess pain (element A), both spontaneous awakening trials (element B1) and spontaneous breathing trials (element B2), choice of sedation (element C), delirium assessment (element D), early mobilization (element E), and family engagement (element F). Results: 4165 registered bundle elements were obtained from nursing (47%), physiotherapy (44%), and physicians (7%), including 1134 patient/days (from 133 patients). Elements E and C showed 67 and 40% compliance, while D, A, and B2 showed 24, 14 and 11%, respectively. For B1 and F, 0% compliance was achieved. Compliance was higher in patients without mechanical ventilation for A and E, while it was similar for D. Conclusions: Early mobilization had the highest compliance, while spontaneous awakening trials and family engagement had absolute non-compliance. Future studies should explore the reasons for the different degrees of compliance per bundle element in clinical practice.
MeSH term(s)	Humans ; Retrospective Studies ; Intensive Care Units ; Respiration, Artificial/methods ; Respiration, Artificial/statistics & numerical data ; Male ; Middle Aged ; Female ; Critical Illness ; Aged ; Chile ; Early Ambulation ; Guideline Adherence ; Patient Care Bundles/methods ; Critical Care/methods ; Delirium ; Adult ; Physical Therapy Modalities
Language	Spanish
Publishing date	2024-05-09
Publishing country	Chile
Document type	Journal Article ; Observational Study
ZDB-ID	2818022-7
ISSN	0717-6384 ; 0717-6384
ISSN (online)	0717-6384
ISSN	0717-6384
DOI	10.5867/medwave.2024.04.2795
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Article ; Online: Respiratory drive, inspiratory effort, and work of breathing: review of definitions and non-invasive monitoring tools for intensive care ventilators during pandemic times.

Ríos-Castro, Francisco / González-Seguel, Felipe / Molina, Jorge

Medwave

2022 Volume 22, Issue 3, Page(s) e8724

Abstract: Technological advances in mechanical ventilation have been essential to increasing the survival rate in intensive care units. Usually, patients needing mechanical ventilation use controlled ventilation to override the patients respiratory muscles and ... ...

Title translation	Impulso, esfuerzo y trabajo respiratorio: revisión de definiciones y herramientas no invasivas de ventiladores de cuidados intensivos durante tiempos de pandemia.
Abstract	Technological advances in mechanical ventilation have been essential to increasing the survival rate in intensive care units. Usually, patients needing mechanical ventilation use controlled ventilation to override the patients respiratory muscles and favor lung protection. Weaning from mechanical ventilation implies a transition towards spontaneous breathing, mainly using assisted mechanical ventilation. In this transition, the challenge for clinicians is to avoid under and over assistance and minimize excessive respiratory effort and iatrogenic diaphragmatic and lung damage. Esophageal balloon monitoring allows objective measurements of respiratory muscle activity in real time, but there are still limitations to its routine application in intensive care unit patients using mechanical ventilation. Like the esophageal balloon, respiratory muscle electromyography and diaphragmatic ultrasound are minimally invasive tools requiring specific training that monitor respiratory muscle activity. Particularly during the coronavirus disease pandemic, non invasive tools available on mechanical ventilators to monitor respiratory drive, inspiratory effort, and work of breathing have been extended to individualize mechanical ventilation based on patients needs. This review aims to identify the conceptual definitions of respiratory drive, inspiratory effort, and work of breathing and to identify non invasive maneuvers available on intensive care ventilators to measure these parameters. The literature highlights that although respiratory drive, inspiratory effort, and work of breathing are intuitive concepts, even distinguished authors disagree on their definitions.
MeSH term(s)	Critical Care ; Humans ; Pandemics ; Respiration, Artificial ; Ventilators, Mechanical ; Work of Breathing/physiology
Language	English
Publishing date	2022-04-29
Publishing country	Chile
Document type	Journal Article ; Review
ZDB-ID	2818022-7
ISSN	0717-6384 ; 0717-6384
ISSN (online)	0717-6384
ISSN	0717-6384
DOI	10.5867/medwave.2022.03.002550
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Article ; Online: Respiratory drive, inspiratory effort, and work of breathing

Francisco Ríos-Castro / Felipe González-Seguel / Jorge Molina

Medwave, Vol 22, Iss 03, Pp e002550-e

review of definitions and non-invasive monitoring tools for intensive care ventilators during pandemic times

2022 Volume 002550

Abstract	Technological advances in mechanical ventilation have been essential to increasing the survival rate in intensive care units. Usually, patients needing mechanical ventilation use controlled ventilation to override the patient’s respiratory muscles and favor lung protection. Weaning from mechanical ventilation implies a transition towards spontaneous breathing, mainly using assisted mechanical ventilation. In this transition, the challenge for clinicians is to avoid under and over assistance and minimize excessive respiratory effort and iatrogenic diaphragmatic and lung damage. Esophageal balloon monitoring allows objective measurements of respiratory muscle activity in real time, but there are still limitations to its routine application in intensive care unit patients using mechanical ventilation. Like the esophageal balloon, respiratory muscle electromyography and diaphragmatic ultrasound are minimally invasive tools requiring specific training that monitor respiratory muscle activity. Particularly during the coronavirus disease pandemic, non invasive tools available on mechanical ventilators to monitor respiratory drive, inspiratory effort, and work of breathing have been extended to individualize mechanical ventilation based on patient’s needs. This review aims to identify the conceptual definitions of respiratory drive, inspiratory effort, and work of breathing and to identify non invasive maneuvers available on intensive care ventilators to measure these parameters. The literature highlights that although respiratory drive, inspiratory effort, and work of breathing are intuitive concepts, even distinguished authors disagree on their definitions.
Keywords	work of breathing ; mechanical ventilation ; ventilator weaning ; intensive care units ; covid- 19 ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	571
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Medwave Estudios Limitada
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Six-month post-intensive care outcomes during high and low bed occupancy due to the COVID-19 pandemic: A multicenter prospective cohort study.

Castro-Avila, Ana / Merino-Osorio, Catalina / González-Seguel, Felipe / Camus-Molina, Agustín / Muñoz-Muñoz, Felipe / Leppe, Jaime

PloS one

2023 Volume 18, Issue 11, Page(s) e0294631

Abstract: Introduction: The COVID-19 pandemic can be seen as a natural experiment to test how bed occupancy affects post-intensive care unit (ICU) patient's functional outcomes. To compare by bed occupancy the frequency of mental, physical, and cognitive ... ...

Abstract	Introduction: The COVID-19 pandemic can be seen as a natural experiment to test how bed occupancy affects post-intensive care unit (ICU) patient's functional outcomes. To compare by bed occupancy the frequency of mental, physical, and cognitive impairments in patients admitted to ICU during the COVID-19 pandemic. Methods: Prospective cohort of adults mechanically ventilated >48 hours in 19 ICUs from seven Chilean public and private hospitals. Ninety percent of nationwide beds occupied was the cut-off for low versus high bed occupancy. At ICU discharge, 3- and 6-month follow-up, we assessed disability using the World Health Organization Disability Assessment Schedule 2.0. Quality of life, mental, physical, and cognitive outcomes were also evaluated following the core outcome set for acute respiratory failure. Results: We enrolled 252 participants, 103 (41%) during low and 149 (59%) during high bed occupancy. Patients treated during high occupancy were younger (P50 [P25-P75]: 55 [44-63] vs 61 [51-71]; p<0.001), more likely to be admitted due to COVID-19 (126 [85%] vs 65 [63%]; p<0.001), and have higher education qualification (94 [63%] vs 48 [47%]; p = 0.03). No differences were found in the frequency of at least one mental, physical or cognitive impairment by bed occupancy at ICU discharge (low vs high: 93% vs 91%; p = 0.6), 3-month (74% vs 63%; p = 0.2) and 6-month (57% vs 57%; p = 0.9) follow-up. Conclusions: There were no differences in post-ICU outcomes between high and low bed occupancy. Most patients (>90%) had at least one mental, physical or cognitive impairment at ICU discharge, which remained high at 6-month follow-up (57%). Clinical trial registration: NCT04979897 (clinicaltrials.gov).
MeSH term(s)	Adult ; Humans ; Bed Occupancy ; Prospective Studies ; COVID-19/epidemiology ; Pandemics ; Quality of Life ; Critical Care ; Intensive Care Units
Language	English
Publishing date	2023-11-16
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0294631
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Effectiveness of physical rehabilitation interventions in critically ill patients-A protocol for an overview of systematic reviews.

Gutierrez-Arias, Ruvistay / Nydahl, Peter / Pieper, Dawid / González-Seguel, Felipe / Jalil, Yorschua / Oliveros, Maria-Jose / Torres-Castro, Rodrigo / Seron, Pamela

PloS one

2023 Volume 18, Issue 4, Page(s) e0284417

Abstract: Introduction: Adult and pediatric patients admitted to intensive care units (ICUs) requiring invasive ventilatory support, sedation, and muscle blockade may present neuromusculoskeletal deterioration. Different physical rehabilitation interventions have ...

Abstract	Introduction: Adult and pediatric patients admitted to intensive care units (ICUs) requiring invasive ventilatory support, sedation, and muscle blockade may present neuromusculoskeletal deterioration. Different physical rehabilitation interventions have been studied to evaluate their effectiveness in improving critically ill patients' outcomes. Given that many published systematic reviews (SRs) aims to determine the effectiveness of different types of physical rehabilitation interventions, it is necessary to group them systematically and assess the methodological quality of SRs to help clinicians make better evidence-based decisions. This overview of SRs (OoSRs) aims to map the existing evidence and to determine the effectiveness of physical rehabilitation interventions to improve neuromusculoskeletal function and other clinical outcomes in adult and pediatric critically ill patients. Methods: An OoSRs of randomized and non-randomized clinical trials involving critically ill adult and pediatric patients receiving physical rehabilitation intervention will be conducted. A sensitive search of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Cochrane Library, Epistemonikos, and other search resources will be conducted. Two independent reviewers will conduct study selection, data extraction, and methodological quality assessment. Discrepancies will be resolved by consensus or a third reviewer. The degree of overlap of studies will be calculated using the corrected covered area. The methodological quality of the SRs will be measured using the AMSTAR-2 tool. The GRADE framework will report the certainty of evidence by selecting the "best" SR for each physical rehabilitation intervention and outcome. Discussion: The findings of this overview are expected to determine the effectiveness and safety of physical rehabilitation interventions to improve neuromusculoskeletal function in adult and pediatric critically ill patients based on a wide selection of the best available evidence and to determine the knowledge gaps in this topic by mapping and assessing the methodological quality of published SRs. Registration number: CRD42023389672.
MeSH term(s)	Adult ; Child ; Humans ; Critical Illness ; Hospitalization ; Intensive Care Units ; Systematic Reviews as Topic
Language	English
Publishing date	2023-04-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0284417
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Article ; Online: Assessment of redundancy, methodological and reporting quality, and potential discrepancies of results of systematic reviews of early mobilisation of critically ill adults: a meta-research protocol.

Gutierrez-Arias, Ruvistay / Pieper, Dawid / Nydahl, Peter / González-Seguel, Felipe / Jalil, Yorschua / Oliveros, Maria-Jose / Torres-Castro, Rodrigo / Seron, Pamela

BMJ open

2023 Volume 13, Issue 7, Page(s) e074615

Abstract: Introduction: Several systematic reviews (SRs) have been conducted to determine the effectiveness of early mobilisation in critically ill adults with heterogeneous methodology and results. Redundancy in conducting SRs, unclear justification when leading ...

Abstract	Introduction: Several systematic reviews (SRs) have been conducted to determine the effectiveness of early mobilisation in critically ill adults with heterogeneous methodology and results. Redundancy in conducting SRs, unclear justification when leading new SRs or updating, and discordant results of SRs on the same research question may generate research waste that makes it difficult for clinicians to keep up to date with the best available evidence. This meta-research aims to assess the redundancy, methodological and reporting quality, and potential reasons for discordance in the results reported by SRs conducted to determine the effectiveness of early mobilisation in critically ill adult patients. Methods and analysis: A meta-research of early mobilisation SRs in critically ill adult patients will be conducted. A search of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Cochrane Library, Epistemonikos and other search resources will be conducted. Two independent reviewers will perform study selection, data extraction and quality appraisal. Discrepancies will be resolved by consensus or a third reviewer. The redundancy of SRs will be assessed by the degree of overlap of primary studies. In addition, the justification for conducting new SRs will be evaluated with the 'Evidence-Based Research' framework. The methodological quality of the SRs will be assessed with the A MeaSurement Tool to Assess systematic Reviews 2 tool, and the quality of the reports through compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. To assess the potential reasons for discordance in the results of the SRs considering divergence in results and their interpretation. Ethics and dissemination: As meta-research, this study does not involve the participation of people whose rights may be violated. However, this overview will be developed rigorously and systematically to achieve valid and reliable results. The findings of this meta-research study will be presented at conferences and published in a peer-reviewed journal related to rehabilitation, critical care or research methodology. Trial registration number: osf.io/kxwq9.
MeSH term(s)	Adult ; Humans ; Critical Illness/therapy ; Early Ambulation ; Critical Care ; Research Design ; Peer Review
Language	English
Publishing date	2023-07-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-074615
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Article: MyoVision-US: an Artificial Intelligence-Powered Software for Automated Analysis of Skeletal Muscle Ultrasonography.

Calulo Rivera, Zoe / González-Seguel, Felipe / Horikawa-Strakovsky, Arimitsu / Granger, Catherine / Sarwal, Aarti / Dhar, Sanjay / Ntoumenopoulos, George / Chen, Jin / Bumgardner, V K Cody / Parry, Selina M / Mayer, Kirby P / Wen, Yuan

medRxiv : the preprint server for health sciences

2024

Abstract: Introduction/aims: Muscle ultrasound has high utility in clinical practice and research; however, the main challenges are the training and time required for manual analysis to achieve objective quantification of morphometry. This study aimed to develop ... ...

Abstract	Introduction/aims: Muscle ultrasound has high utility in clinical practice and research; however, the main challenges are the training and time required for manual analysis to achieve objective quantification of morphometry. This study aimed to develop and validate a software tool powered by artificial intelligence (AI) by measuring its consistency and predictability of expert manual analysis quantifying lower limb muscle ultrasound images across healthy, acute, and chronic illness subjects. Methods: Quadriceps complex (QC [rectus femoris and vastus intermedius]) and tibialis anterior (TA) muscle ultrasound images of healthy, intensive care unit, and/or lung cancer subjects were captured with portable devices. Automated analyses of muscle morphometry were performed using a custom-built deep-learning model (MyoVision-US), while manual analyses were performed by experts. Consistency between manual and automated analyses was determined using intraclass correlation coefficients (ICC), while predictability of MyoVision -US was calculated using adjusted linear regression (adj.R Results: Manual analysis took approximately 24 hours to analyze all 180 images, while MyoVision - US took 247 seconds, saving roughly 99.8%. Consistency between the manual and automated analyses by ICC was good to excellent for all QC (ICC:0.85-0.99) and TA (ICC:0.93-0.99) measurements, even for critically ill (ICC:0.91-0.98) and lung cancer (ICC:0.85-0.99) images. The predictability of MyoVision-US was moderate to strong for QC (adj.R Discussion: The application of AI automating lower limb muscle ultrasound analyses showed excellent consistency and strong predictability compared with human analysis. Future work needs to explore AI-powered models for the evaluation of other skeletal muscle groups.
Language	English
Publishing date	2024-04-30
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.04.26.24306153
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Article ; Online: Adverse Events of Prone Positioning in Mechanically Ventilated Adults With ARDS.

González-Seguel, Felipe / Pinto-Concha, Juan José / Aranis, Nadine / Leppe, Jaime

Respiratory care

2021 Volume 66, Issue 12, Page(s) 1898–1911

Abstract: Background: Prone positioning is a therapy utilized globally to improve gas exchange, minimize ventilator-induced lung injury, and reduce mortality in ARDS, particularly during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Whereas the ... ...

Abstract	Background: Prone positioning is a therapy utilized globally to improve gas exchange, minimize ventilator-induced lung injury, and reduce mortality in ARDS, particularly during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Whereas the respiratory benefits of prone positioning in ARDS have been accepted, the concurrent complications could be undervalued. Therefore, this study aimed to identify the adverse events (AEs) related to prone positioning in ARDS and, secondarily, to collect strategies and recommendations to mitigate these AEs. Methods: In this scoping review, we searched recommendation documents and original studies published between June 2013 and November 2020 from 6 relevant electronic databases and the websites of intensive care societies. Results: We selected 41 documents from 121 eligible documents, comprising 13 recommendation documents and 28 original studies (involving 1,578 subjects and 994 prone maneuvers). We identified > 40 individual AEs, and the highest-pooled occurrence rates were those of severe desaturation (37.9%), barotrauma (30.5%), pressure sores (29.7%), ventilation-associated pneumonia (28.2%), facial edema (16.7%), arrhythmia (15.4%), hypotension (10.2%), and peripheral nerve injuries (8.1%). The reported mitigation strategies during prone positioning included alternate face rotation (18 [43.9%]), repositioning every 2 h (17 [41.5%]), and the use of pillows under the chest and pelvis (14 [34.1%]). The reported mitigation strategies for performing the prone maneuver comprised one person being at the headboard (23 [56.1%]), the use of a pre-maneuver safety checklist (18 [43.9%]), vital sign monitoring (15 [36.6%]), and ensuring appropriate ventilator settings (12 [29.3%]). Conclusions: We identified > 40 AEs reported in prone positioning ARDS studies, including additional AEs not yet reported by previous systematic reviews. The pooled AE proportions collected in this review could guide research and clinical practice decisions, and the strategies to mitigate AEs could promote future consensus-based recommendations.
MeSH term(s)	Adult ; COVID-19 ; Humans ; Patient Positioning ; Prone Position ; Respiration, Artificial/adverse effects ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/therapy ; SARS-CoV-2
Language	English
Publishing date	2021-07-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	603252-7
ISSN	1943-3654 ; 0098-9142 ; 0020-1324
ISSN (online)	1943-3654
ISSN	0098-9142 ; 0020-1324
DOI	10.4187/respcare.09194
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