Usefulness of low tidal volume ventilation strategy for patients with acute respiratory distress syndrome: a systematic review and meta-analysis
Abstract The effects of lower tidal volume ventilation (LTV) were controversial for patients with acute respiratory distress syndrome (ARDS). This systematic review and meta-analysis aimed to evaluate the use of LTV strategy in patients with ARDS. We performed a literature search on MEDLINE, CENTRAL...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-06-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-13224-y |
| _version_ | 1817971045962874880 |
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| author | Ryohei Yamamoto Satoru Robert Okazaki Yoshihito Fujita Nozomu Seki Yoshufumi Kokei Shusuke Sekine Soichiro Wada Yasuhiro Norisue Chihiro Narita |
| author_facet | Ryohei Yamamoto Satoru Robert Okazaki Yoshihito Fujita Nozomu Seki Yoshufumi Kokei Shusuke Sekine Soichiro Wada Yasuhiro Norisue Chihiro Narita |
| author_sort | Ryohei Yamamoto |
| collection | DOAJ |
| description | Abstract The effects of lower tidal volume ventilation (LTV) were controversial for patients with acute respiratory distress syndrome (ARDS). This systematic review and meta-analysis aimed to evaluate the use of LTV strategy in patients with ARDS. We performed a literature search on MEDLINE, CENTRAL, EMBASE, CINAHL, “Igaku-Chuo-Zasshi”, clinical trial registration sites, and the reference of recent guidelines. We included randomized controlled trials (RCTs) to compare the LTV strategy with the higher tidal volume ventilation (HTV) strategy in patients with ARDS. Two authors independently evaluated the eligibility of studies and extracted the data. The primary outcomes were 28-day mortality. We used the GRADE methodology to assess the certainty of evidence. Among the 19,864 records screened, 13 RCTs that recruited 1874 patients were included in our meta-analysis. When comparing LTV (4–8 ml/kg) versus HTV (> 8 ml/kg), the pooled risk ratio for 28-day mortality was 0.79 (11 studies, 95% confidence interval [CI] 0.66–0.94, I2 = 43%, n = 1795, moderate certainty of evidence). Subgroup-analysis by combined high positive end-expiratory pressure with LTV showed interaction (P = 0.01). Our study indicated that ventilation with LTV was associated with reduced risk of mortality in patients with ARDS when compared with HTV. Trial registration: UMIN-CTR (UMIN000041071). |
| first_indexed | 2024-04-13T20:41:50Z |
| format | Article |
| id | doaj.art-74b5933a4c4a4f92a73ed96e47ce6da5 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-13T20:41:50Z |
| publishDate | 2022-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-74b5933a4c4a4f92a73ed96e47ce6da52022-12-22T02:30:50ZengNature PortfolioScientific Reports2045-23222022-06-0112111210.1038/s41598-022-13224-yUsefulness of low tidal volume ventilation strategy for patients with acute respiratory distress syndrome: a systematic review and meta-analysisRyohei Yamamoto0Satoru Robert Okazaki1Yoshihito Fujita2Nozomu Seki3Yoshufumi Kokei4Shusuke Sekine5Soichiro Wada6Yasuhiro Norisue7Chihiro Narita8Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto UniversityDepartment of Intensive Care Medicine, Kameda Medical CenterDepartment of Anesthesiology and Intensive Care Medicine, Aichi Medical UniversityEmergency Department, Toyama University HospitalDepartment of Emergency Medicine Trauma and Resuscitation Center, Tokyo Metropolitan Tama Medical CenterDepartment of Anesthesiology, Tokyo Medical UniversityDepartment of Pediatrics, Teine Keijinkai HospitalDepartment of Emergency and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical CenterDepartmenet of Emergency Medicine, Shizuoka General HospitalAbstract The effects of lower tidal volume ventilation (LTV) were controversial for patients with acute respiratory distress syndrome (ARDS). This systematic review and meta-analysis aimed to evaluate the use of LTV strategy in patients with ARDS. We performed a literature search on MEDLINE, CENTRAL, EMBASE, CINAHL, “Igaku-Chuo-Zasshi”, clinical trial registration sites, and the reference of recent guidelines. We included randomized controlled trials (RCTs) to compare the LTV strategy with the higher tidal volume ventilation (HTV) strategy in patients with ARDS. Two authors independently evaluated the eligibility of studies and extracted the data. The primary outcomes were 28-day mortality. We used the GRADE methodology to assess the certainty of evidence. Among the 19,864 records screened, 13 RCTs that recruited 1874 patients were included in our meta-analysis. When comparing LTV (4–8 ml/kg) versus HTV (> 8 ml/kg), the pooled risk ratio for 28-day mortality was 0.79 (11 studies, 95% confidence interval [CI] 0.66–0.94, I2 = 43%, n = 1795, moderate certainty of evidence). Subgroup-analysis by combined high positive end-expiratory pressure with LTV showed interaction (P = 0.01). Our study indicated that ventilation with LTV was associated with reduced risk of mortality in patients with ARDS when compared with HTV. Trial registration: UMIN-CTR (UMIN000041071).https://doi.org/10.1038/s41598-022-13224-y |
| spellingShingle | Ryohei Yamamoto Satoru Robert Okazaki Yoshihito Fujita Nozomu Seki Yoshufumi Kokei Shusuke Sekine Soichiro Wada Yasuhiro Norisue Chihiro Narita Usefulness of low tidal volume ventilation strategy for patients with acute respiratory distress syndrome: a systematic review and meta-analysis Scientific Reports |
| title | Usefulness of low tidal volume ventilation strategy for patients with acute respiratory distress syndrome: a systematic review and meta-analysis |
| title_full | Usefulness of low tidal volume ventilation strategy for patients with acute respiratory distress syndrome: a systematic review and meta-analysis |
| title_fullStr | Usefulness of low tidal volume ventilation strategy for patients with acute respiratory distress syndrome: a systematic review and meta-analysis |
| title_full_unstemmed | Usefulness of low tidal volume ventilation strategy for patients with acute respiratory distress syndrome: a systematic review and meta-analysis |
| title_short | Usefulness of low tidal volume ventilation strategy for patients with acute respiratory distress syndrome: a systematic review and meta-analysis |
| title_sort | usefulness of low tidal volume ventilation strategy for patients with acute respiratory distress syndrome a systematic review and meta analysis |
| url | https://doi.org/10.1038/s41598-022-13224-y |
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