Trunk Inclination Changes Worsen Compliance and Raise PaCO2 in Obese ARDS Patients: Clinical Implications from a Seven-Study Pooled Analysis

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– Increasing trunk inclination during passive mechanical ventilation reduces respiratory system, lung, and chest wall compliance; effects are larger in patients with obesity.
– Only obese patients demonstrated a clinically meaningful rise in arterial CO2 (PaCO2) with increased trunk inclination.
– No consistent change in oxygenation (PaO2/FiO2) was observed across groups; study heterogeneity limits definitive practice recommendations.

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