However, if a patient's blood pressure or oxygen level drops to a dangerously low reading during the position change, urgent medical attention is required. Routine lateral repositioning is a relatively safe standard practice. Turning from side to side may also help loosen and drain secretions accumulated within the lungs. Nurses change the body position of critically ill patients as frequently as every two hours to prevent bed sores and other complications associated with immobility. We reviewed the evidence on the effects of turning critically ill adults from side to side while lying on a hospital bed. Lateral positioning for critically ill adult patients We had similar doubts regarding internal validity for other studies included in the review. Furthermore, pooled data had methodological shortcomings with unclear risk of bias. Despite a lower mean PaO 2 for bad lung down, hypoxaemia (mean PaO 2 < 60 mmHg) was not consistently reported. The mean difference (MD) between lateral positions (bad lung down versus good lung down) was approximately 50 mmHg (MD ‐49.26 mmHg, 95% confidence interval (CI) ‐67.33 to ‐31.18 P value < 0.00001). We pooled partial pressure of arterial oxygen (PaO 2) as a measure to detect hypoxaemia from two small studies of participants with unilateral lung disease (n = 19). Eight studies provided some data most of these were single studies with small effects that were imprecise. However, parallel‐group studies were not comparable, and cross‐over studies provided limited data as the result of unit of analysis errors. A total of 22 randomized trials examined effects of lateral positioning (four parallel‐group and 18 cross‐over designs) by measuring various continuous data outcomes commonly used to detect adverse cardiopulmonary events within critical care areas. Two randomized controlled trials (RCTs) examined lateral positioning for pulmonary morbidity outcomes but provided insufficient information for meta‐analysis. No study reported mortality as an outcome of interest. We included 24 studies of critically ill adults.
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