التفاصيل البيبلوغرافية
| العنوان: |
Effect of lung recruitment maneuver on oxygenation, physiological parameters and mortality in acute respiratory distress syndrome patients: a systematic review and meta-analysis. |
| المؤلفون: |
Pensier, Joris, de Jong, Audrey, Hajjej, Zied, Molinari, Nicolas, Carr, Julie, Belafia, Fouad, Chanques, Gérald, Futier, Emmanuel, Azoulay, Elie, Jaber, Samir |
| المصدر: |
Intensive Care Medicine; Dec2019, Vol. 45 Issue 12, p1691-1702, 12p, 1 Diagram, 3 Charts, 1 Graph |
| مصطلحات موضوعية: |
ADULT respiratory distress syndrome, META-analysis, INTENSIVE care patients, LUNGS, MORTALITY, ADULT respiratory distress syndrome treatment, COMPARATIVE studies, RESEARCH methodology, MEDICAL cooperation, RESEARCH, RESPIRATORY organ physiology, EVALUATION research, POSITIVE end-expiratory pressure |
| مستخلص: |
Purpose: Among acute respiratory distress syndrome (ARDS) patients in intensive care units, the efficacy of lung recruitment maneuver (LRM) use is uncertain taking into account the most recent randomized controlled trials (RCTs). We aimed to estimate the effect of LRMs on mortality from ARDS.Methods: In this systematic review and meta-analysis, we searched for RCTs comparing mechanical ventilation with and without LRMs in adults with ARDS. We generated pooled relative risks (RR), mean difference, performed trial-sequential-analysis and cumulative meta-analysis. The primary outcome was 28-day mortality. The secondary outcomes were oxygenation evaluated by PaO2/FiO2 ratio, rate of rescue therapy and rate of hemodynamic compromise.Results: In 14 RCTs including 3185 patients, LRMs were not associated with reduced 28-day mortality (RR = 0.92, 95% confidence interval (95% CI) 0.82-1.04, P = 0.21), compared to no-LRM. Trial-sequential-analysis showed that the required information size has been accrued. PaO2/FiO2 ratio was significantly higher in the LRMs group in comparison to the no-LRM group (mean difference = 47.6 mmHg, 95% CI 33.4-61.8, P < 0.001). LRMs were associated with a decreased rate of rescue therapy (RR = 0.69 95% CI 0.56-0.84, P < 0.001), and an increased rate of hemodynamic compromise (RR = 1.19, 95% CI 1.06-1.33, P = 0.002), compared to no-LRM group. Using cumulative meta-analysis, a significant change for effect on mortality was observed after 2017.Conclusions: The results suggest that in ARDS patients, systematic use of LRMs does not significantly improve 28-day mortality. However, LRM use was associated with positive effects such as an oxygenation improvement and a less frequent use of rescue therapy. Nevertheless, LRM use was associated with negative effects such as hemodynamic impairment. [ABSTRACT FROM AUTHOR] |
|
Copyright of Intensive Care Medicine is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
