Effect of lateral versus supine positioning on hypoxaemia in sedated adults: multicentre randomised controlled trial

作者：Hui Ye, Lihua Chu, Guo-Hao Xie, Ye-Jing Hua, Yi Lou, Qiao-Hong Wang, Zhixin Xu, Meng-Yan Tang, Bing Wang, Huiyi Hu, Ying Jing, Tianbo Yu, Haiying Wang, Yuan Wang, Zhijian Ye, Xiao-Fang Bao, Ming-Cang Wang, Lingyang Chen, Xiaoxia Wang, Xing-Bo Zhang, Changshun Huang, Jun Wang, Yaping Lu, Foquan Luo, Zhou Wang, Chuan-Guang Wang, Hao Cheng, Wenjie Liu, Jie Luo, Yanqin Wu, Ru-Ru Li, Dong Wang, Ling-Qian Hou, Lu Shi, Jun Zhang, Kun Wang, Xin Pi, Rong Zhou, Qinqin Yang, Pei-Ling Wan, Hui Li, Shuijing Wu, Shengwen Song, Ping Cui, Liqi Shu, Nazrul Islam, Xiangming Fang · 发表于：BMJ · 年份：2025 · DOI：10.1136/bmj-2025-084539 · 被引用次数：7 · 研究领域：Airway Management and Intubation Techniques、Respiratory Support and Mechanisms、Anesthesia and Sedative Agents

Abstract Objectives To evaluate the effect of lateral versus supine positioning on incidence of hypoxaemia in sedated patients and to provide evidence based recommendations for respiratory strategies. Design Prospective, multicentre, randomised controlled trial. Setting 14 tertiary hospitals in China, July to November 2024. Participants 2159 adults (≥18 years) who underwent sedation. Interventions Sedated patients were randomly assigned (1:1) to receive either lateral positioning or conventional supine positioning, stratified by study centres. Main outcome measures The primary outcome was incidence of hypoxaemia (peripheral oxygen saturation (SpO 2 ) ≤90%) within the first 10 minutes after positioning. Secondary outcomes included airway rescue interventions, incidence of severe hypoxaemia (SpO 2 ≤85%), lowest oxygen saturation recorded, length of stay in the post-anaesthesia care unit, and safety measures (eg, bradycardia, tachycardia, hypotension, new onset arrhythmia). Analyses were performed on an intention-to-treat basis. Results Of 2159 patients randomised, 2143 were included in the primary analysis. The mean age of the patients was 53.1 years, mean body mass index was 23.9, and 53.7% (1150/2143) were women. The incidence of hypoxaemia was significantly lower in the lateral group compared with supine group (5.4% (58/1073) v 15.0% (161/1070); adjusted risk ratio 0.36, 95% confidence interval (CI) 0.27 to 0.49; P<0.001). Compared with patients in the supine group, patie...