Body position for preventing ventilator-associated pneumonia for critically ill patients: a systematic review and network meta-analysis.

Although the prone position showed a beneficial effect relative to the semi-recumbent and supine positions, the effect estimates did not reach statistical significance (Table 2 ) (Additional file 2 ).

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Indirect comparisons showed a positive trend towards a decrease in the incidence of VAP in all body positions when they were compared with the supine position; nevertheless, none of these results reached statistical significance (Table 2 ).

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In fact, a previous nonrandomized trial showed a trend to reduce the incidence of VAP in the lateral–horizontal position group compared to the semi-recumbent position group, and no serious adverse events occurred in patients positioned in lateral–horizontal decubitus; nevertheless, this study was not conclusive, which may be due to its small sample size.

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