Influence of different lying positions on monitoring of central venous pressure in patients with mechanical ventilation: a systematic review

Abstract

Objective To review systematically the influence of different lying positions on monitoring of central venous pressure (CVP) in patients with mechanical ventilation. Methods Relevant articles published publicly from database establishment date to June, 30th, 2018 in PubMed, Cochrane Library, Embase, Web of Science, CBM, Chinese Academic Journal Full-text Database (CJFD) , Wanfang and VIP Database were searched on computer. Two researchers independently screened and extracted the literature. RevMan 5.3 software was used for meta-analysis of the included studies. Results Nine literatures were included, including 380 subjects. Meta-analysis showed that there were significant statistical differences in CVP values between 30 degree semi-recumbent position and supine position (WMD=-0.70, 95%CI: -1.15--0.24, P=0.003) , and between 45 degree semi-recumbent position and supine position (WMD=-1.34, 95%CI: -1.82--0.86, P<0.001) , and between 60 degree semi-recumbent position and supine position (WMD=-2.96, 95%CI: -3.91--2.00, P<0.001) . Conclusions There are differences between the CVP measurements in the 30°, 45°, 60° hemi-recumbent position and the supine position. To ensure the accuracy of the CVP measurement values in mechanical ventilation patients, we should take the supine position for measurement. Key words: Central venous pressure; Lying position; Monitoring; Mechanical ventilation; Systematic review