Higher vs. Lower DP for Ventilated Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis
Joint Authors
Sun, Jia-Qi
Jia, Xiaopeng
Chen, Zhen
Liu, Genglong
Wei, Xuxia
Tai, Qiang
Zheng, Donghua
Xie, Wenfeng
Chen, Li
Wang, Ganping
Wang, Siqi
Liu, Na
Lv, Haijin
Source
Emergency Medicine International
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-12, 12 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-07-18
Country of Publication
Egypt
No. of Pages
12
Main Subjects
Abstract EN
Objectives.
Driving pressure (DP) has recently become a promising mediator for the identification of the effects of mechanical ventilation on outcomes in acute respiratory distress syndrome (ARDS).
The aim of this study was to systematically and quantitatively update and assess the association between DP and mortality among ventilated patients with ARDS.
Methods.
PubMed, the Cochrane Library, ISI Web of Knowledge, and Embase were systematically searched from inception to June 2018.
Two investigators conducted the literature search study selection, data extraction, and quality evaluation independently.
RevMan 5.3 software was used for all statistical analyses.
Results.
A total of seven studies comprising 8010 patients were included in this meta-analysis.
Higher DP showed a significant association with higher mortality (pooled risk ratio, 1.10; 95% [CI], 1.05–1.16; I2 =58%).
Sensitivity analysis indicated that one study significantly affected the stability of pooled results.
One of the subgroups investigated, ARDS severity, could account for the heterogeneity.
An exploratory post hoc subgroup analysis and higher DP significantly increased mortality in the mild to severe ARDS subgroup (RR 1.28; 95% [CI], 1.14–1.43; I2 =0), but not in the moderate to severe ARDS subgroup (RR 1.18; 95% [CI], 0.95–1.46; I2 =52%).
Conclusion.
Higher DP was significantly associated with an increased risk of death among ventilated patients with ARDS.
But it did not seem to predict prognosis to moderate to severe ARDS.
Future prospective randomized clinical trials are needed to verify the results of this meta-analysis and address the unresolved questions about optimum cutoff values for DP.
Trial Registration.
This trial is registered with PROSPERO (CRD42018102146), on 11 August 2018.
American Psychological Association (APA)
Chen, Zhen& Wei, Xuxia& Liu, Genglong& Tai, Qiang& Zheng, Donghua& Xie, Wenfeng…[et al.]. 2019. Higher vs. Lower DP for Ventilated Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis. Emergency Medicine International،Vol. 2019, no. 2019, pp.1-12.
https://search.emarefa.net/detail/BIM-1152214
Modern Language Association (MLA)
Chen, Zhen…[et al.]. Higher vs. Lower DP for Ventilated Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis. Emergency Medicine International No. 2019 (2019), pp.1-12.
https://search.emarefa.net/detail/BIM-1152214
American Medical Association (AMA)
Chen, Zhen& Wei, Xuxia& Liu, Genglong& Tai, Qiang& Zheng, Donghua& Xie, Wenfeng…[et al.]. Higher vs. Lower DP for Ventilated Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis. Emergency Medicine International. 2019. Vol. 2019, no. 2019, pp.1-12.
https://search.emarefa.net/detail/BIM-1152214
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1152214