Evidence map›Paper›PMID 40298974›Full record

SynthesisIntensive care medicine2025

Prone positioning during veno-venous extracorporeal membrane oxygenation: a systematic review and meta-analysis.

Tommaso Pettenuzzo, Eleonora Balzani, Nicolò Sella, Marco Giani, Mara Bassi, Valentina Fincati, Rossella Cescon, Giorgia Pacchiarini, Giovanna Pandolfo, Roberta Ceccato and 13 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Intensive care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Tommaso Pettenuzzo *Institute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy.
Eleonora Balzani *Department of Surgical Sciences, University of Turin, Turin, Italy.
Nicolò SellaInstitute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy.
Marco GianiEmergency Medicine Department, San Gerardo Hospital, Monza, Italy.
Mara BassiDepartment of Medicine, University of Padua, Padua, Italy.
Valentina FincatiDepartment of Medicine, University of Padua, Padua, Italy.
Rossella CesconDepartment of Medicine, University of Padua, Padua, Italy.
Giorgia PacchiariniInstitute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy.
Giovanna PandolfoDepartment of Medicine, University of Padua, Padua, Italy.
Roberta CeccatoDepartment of Medicine, University of Padua, Padua, Italy.
Lars GrønlykkeDepartment of Cardiothoracic Anesthesia and Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Dawid L StaudacherDepartment of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, University of Freiburg, Freiburg, Germany.
Nicolas NesselerDepartment of Anesthesia and Critical Care, Rennes University Hospital, Rennes, France.
Senta Jorinde RaasveldDepartment of Critical Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Michele CarronInstitute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy.
Elisa PistollatoDepartment of Medicine, University of Padua, Padua, Italy.
Giulia MormandoDepartment of Medicine, University of Padua, Padua, Italy.
Francesco ZarantonelloInstitute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy.
Alessandro De CassaiInstitute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy.
Annalisa BoscoloInstitute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy.
Emanuele RezoagliEmergency Medicine Department, San Gerardo Hospital, Monza, Italy.
Giuseppe FotiEmergency Medicine Department, San Gerardo Hospital, Monza, Italy.
Paolo NavalesiInstitute of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy. paolo.navalesi@unipd.it.ORCID 0000-0002-3733-3453

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe evidence supporting the benefit on clinical outcomes of prone positioning during veno-venous extracorporeal membrane oxygenation (V-V ECMO) for acute hypoxemic respiratory failure remains inconclusive. We aimed to assess the association of prone positioning, compared to no prone positioning, with 28-day mortality and other clinical outcomes in different patient subgroups.

methodsA systematic review and meta-analysis of randomized and non-randomized controlled trials (RCTs) using a random-effects model was conducted. An electronic database search up to September 1st, 2024 was performed (PROSPERO CRD42024517602). The RoB 2 and ROBINS-I tools were used for risk of bias assessments.

resultsWe analyzed two RCTs and 20 non-RCTs (3,465 patients). Compared to no prone positioning, the use of prone positioning was associated with lower 28-day (odds ratio [OR] 0.64, 95% confidence interval [CI] 0.42-0.98, p = 0.040, I

conclusionIn this analysis, among patients supported with V-V ECMO for acute hypoxemic respiratory failure, we observed improved 28-day and hospital mortality in those who received prone positioning, compared to those who did not. However, these findings do not imply causation. Further research is needed to clarify the role of prone positioning in this population.

Indexed as

Extracorporeal Membrane OxygenationPatient PositioningRespiratory InsufficiencyHospital MortalityHumansProne PositionAcute hypoxemic respiratory failureMeta-analysisProne positioningSystematic reviewVeno-venous extracorporeal membrane oxygenation

Identifiers

PMID40298974
PMCPMC12129859

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.