Evidence map›Paper›PMID 42844551›Full record

ArticleNeurocritical care2026

Prone Positioning in Neurocritical Care Patients with Invasive Intracranial Pressure Monitoring: A Systematic Review and Meta-analysis.

Annika Meyer, Remco Overbeek, Laura Mühlhausen, Jan Küchler, Claudia Ditz, André Foit, Marion Hof, Roland Goldbrunner, Andrea U Steinbicker

Abstract read
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Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Annika MeyerFaculty of Medicine, Department of Anesthesiology and Operative Intensive Care, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany. Annika.meyer@uk-koeln.de.ORCID http://orcid.org/0000-0002-8411-8799
Remco OverbeekFaculty of Medicine, Department of Anesthesiology and Operative Intensive Care, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Laura MühlhausenFaculty of Medicine, Center for Neurosurgery, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Jan KüchlerDepartment of Neurosurgery and Spinal Surgery, Helios Clinics of Schwerin, University Campus of MSH Medical School Hamburg, Schwerin, Germany.
Claudia DitzDepartment of Neurosurgery, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
André FoitFaculty of Medicine, Department of Anesthesiology and Operative Intensive Care, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Marion HofFaculty of Medicine, Center for Neurosurgery, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Roland GoldbrunnerFaculty of Medicine, Center for Neurosurgery, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Andrea U SteinbickerFaculty of Medicine, Department of Anesthesiology and Operative Intensive Care, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPulmonary complications are common after acute brain injury and may worsen neurologic outcomes. Although prone positioning (PP) is an established treatment strategy for acute respiratory distress syndrome (ARDS) with severe hypoxemia in general intensive care unit populations, it is often avoided in neurocritical care due to concerns that PP may increase intracranial pressure (ICP). However, evidence supporting these concerns remains limited.

methodsA systematic search of multiple databases and supplementary sources using keywords related to ICP and PP yielded 778 records. Ten studies with 177 patients met the inclusion criteria for the systematic review and eight (n = 120 patients) provided extractable data for meta-analysis of the primary outcome [change in ICP from baseline (supine) to PP]. Pooled means and mean differences were calculated using random-effects models.

resultsThe pooled within-subject mean change in ICP from baseline to PP was + 5.06 mm Hg (95% CI 2.05-8.06; I

conclusionsIn patients with acute brain injury, PP improves systemic and brain tissue oxygenation while causing a modest, transient increase in ICP that resolves after resupination. These findings support cautious use of PP in selected neurocritical care patients with respiratory failure when invasive ICP monitoring is available. Given the limited evidence base, larger prospective studies are needed.

Indexed as

Acute brain injuryARDSCerebral perfusion pressureInvasive intracranial pressureProne positioning

Identifiers

PMID42844551

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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.