Semi-recumbent position for the prevention of ventilator-associated pneumonia in adults requiring mechanical ventilation.
Jiang W et al., 2026 · 48 studies included
Summary
Forty-eight randomized studies, 7,955 ventilated adults, comparing semi-recumbent, supine, lateral and different head-of-bed angles.
Conclusion
Versus supine, semi-recumbency reduced clinically suspected VAP (RR 0.42, 95% CI 0.33–0.52; high certainty), but microbiologically confirmed VAP and mortality did not clearly improve. Higher angles increased pressure injuries in some comparisons (moderate certainty). Use positioning within a prevention bundle, reassessing skin, hemodynamics and contraindications; do not infer universal benefit from a specific angle or adopt lateral rotation from rankings alone.