Efficacy and safety of prone positioning in patients undergoing extracorporeal membrane oxygenation (ECMO): A systematic review and meta-analysis
Authors' conclusion
Combining PP with ECMO improves early but not long-term survival in severe ARDS, especially in non-COVID patients, while extending duration of mechanical support and stays.
Study context
- Population
- Adults with acute respiratory distress syndrome (ARDS) undergoing vv-ECMO17 studies
- Comparison
- ECMO with prone positioning vs ECMO without prone positioning
- Outcome
- Survival
Methodological detailsPRISMA guidelines
- PRISMA guidelines
Pooled result
As reported in the abstract
- ECMO+prone positioning (PP) improved 30-day and hospital survival
- No significant improvement in 60-day, 90-day or ICU survival
Further pooled results
ECMO weaning
- No significant improvement in ECMO weaning rates
Oxygenation and PaCO2
- ECMO+PP significantly enhanced oxygenation parameters and reduced PaCO2
Mechanical ventilation and ICU stay (PP timing and frequency)
- Earlier and more frequent PP sessions shortened mechanical ventilation and ICU stays
30-day survival (non-COVID vs COVID subgroup)
- Non-COVID patients had better 30-day survival with ECMO+PP than COVID patients
Original publication
Efficacy and safety of prone positioning in patients undergoing extracorporeal membrane oxygenation (ECMO): A systematic review and meta-analysis. J Clin Anesth. Published 4 March 2025. doi:10.
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