Effect of lateral versus supine positioning on hypoxaemia in sedated adults: multicentre randomised controlled trial
Primary result · Hypoxaemia (SpO2 ≤90%)Result — go to the resultAdjusted relative risk 0.36 95% CI 0.27–0.49Authors' conclusion
Placing sedated adults in the lateral position significantly reduces the incidence and severity of hypoxaemia and decreases the need for airway rescue interventions without compromising safety.
Study context
- Population
- Adults (≥18 years) undergoing sedation, 14 tertiary hospitals in China, July to November 20242,143 in primary analysis
- Participants
- 2,159 adults
- Comparison
- Lateral vs supine positioning
- Lateraln = 1,073
- Supinen = 1,070reference
- Primary endpoint
- Incidence of hypoxaemia (SpO2 ≤90%)
- Follow-up
- First 10 minutes after positioning
Methodological detailsprospective, multicentre, stratified by centre
- Prospective
- Multicentre
- Stratified by centre
Primary result
Hypoxaemia (SpO2 ≤90%)
Adjusted relative risk
0.36
95% CI 0.27–0.49
P < 0.001
Events by treatment group
Lateral vs Supine
adjusted RR 0.36 (95% CI 0.27–0.49); P < 0.001
As reported in the abstract
Secondary outcomes
| Outcome | Lateral | Supine | Adjusted RR (CI) | P value | |
|---|---|---|---|---|---|
| Airway rescue interventions | 6.3% | 13.8% | 0.46 (0.34–0.61) | P < 0.001 | |
| Severe hypoxaemia (SpO2 ≤85%) | 0.7% | 4.8% | 0.16 (0.07–0.33) | P < 0.001 | |
| 0.050.21520Adjusted relative risk (log scale) |
Mean
| Outcome | Lateral | Supine | Absolute adjusted mean difference (95% CI) | P value | |
|---|---|---|---|---|---|
| Lowest SpO2 | 96.9% | 95.7% | 1.20% (0.87%–1.54%) | P < 0.001 | |
| −1012Difference (linear scale) |
Minutes
| Outcome | Lateral | Supine | Absolute adjusted mean difference (minutes) (95% CI) | P value | |
|---|---|---|---|---|---|
| PACU LOS | 38.2 | 40.5 | −2.22 (−3.63 to −0.80) | P = 0.002 | |
| −4−202Difference, minutes (linear scale) |
Safety
Safety outcomes (bradycardia, tachycardia, hypotension, new onset arrhythmia)
- Comparable between groups; tachycardia less frequent in the lateral group
Original publication
Effect of lateral versus supine positioning on hypoxaemia in sedated adults: multicentre randomised controlled trial. BMJ. Published 19 August 2025. doi:10.
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