Respiratory failure & ventilation
Definition and prognostic value of response to prone positioning in ARDS: a systematic review and meta-analysis
Authors' conclusion
Definitions of responsiveness to prone positioning are highly heterogeneous across the literature, and the reported proportion of responders varies widely depending on the definition adopted.
Study context
- Population
- Invasively ventilated patients with ARDS undergoing prone positioning53 non-randomized studies (oxygenation)
- Comparison
- Responders vs non-responders to prone positioning
- Outcome
- Proportion of responders to prone positioning
Methodological detailsrandom-effects model, logit transformation, pairwise meta-analysis
- Random-effects model
- Logit transformation
- Pairwise meta-analysis
Pooled result
As reported in the abstract
Proportion of responders
Pooled proportion of responders, oxygenation response (PaO2/FiO2 change)
68%
95% CI 63–72%
Pooled proportion of responders, alternative definitions (CO2 clearance, respiratory mechanics, ventilation-perfusion matching; 21 studies)
45% to 53%
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Unadjusted mortality, 5 studies at serious risk of bias (sensitivity analysis)I² = 78% · sensitivity analysis | 0.41 (0.25–0.68) | |
| 0.20.5125Odds ratio (log scale) |
Mortality, unadjusted (26 studies)
- Studies reporting reduced mortality risk in responders
- 11 (42%)
Original publication
Definition and prognostic value of response to prone positioning in ARDS: a systematic review and meta-analysis. Crit Care. Published 15 May 2026. doi:10.
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