Long-term complications of prone position ventilation with relevance for acute and postacute rehabilitation: a systematic review of the literature.
Nancy Elmer, Anett REIßHAUER, Katharina Brehm and 2 others
PMID 36441010WHAT IT FOUND
Prone positioning can cause lasting pressure sores, nerve injuries, and reduced quality of life in ARDS survivors.
Most evidence comes from case reports, so specific rehabilitation protocols for these complications cannot yet be established.
Key findings
01Pressure sores and peripheral nerve injuries are the most frequently reported long-term complications of prone positioning.
02ARDS survivors show significantly lower health-related quality of life scores compared to other critically ill patients, regardless of positioning.
03The review found no therapeutic standards for managing these complications because the majority of included studies were case reports.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The majority of included studies were case reports, which cannot establish efficacy of treatments. No risk of bias assessment was performed on the included studies. The search did not use controlled vocabulary (MeSH), potentially missing relevant studies. Only English-language publications were included. None of the included studies directly evaluated the role of long-term prone positioning sequelae in rehabilitation outcomes.
Declared interests
No specific conflicts of interest or funding sources are declared in the provided text.
The easy way to misread this
Do not assume that the poor quality of life and mobility impairments seen in ARDS survivors are caused by prone positioning. The review found no difference in health-related quality of life between prone and supine groups at 12 months; these impairments are likely due to ARDS itself and critical illness myopathy.