Safety and feasibility of lung biopsy in diagnosis of acute respiratory distress syndrome: protocol for a systematic review and meta-analysis

AbstractIntroductionAcute respiratory distress syndrome (ARDS) is a type of acute respiratory failure characterized by non-cardiac pulmonary edema caused by various underlying conditions. ARDS is often pathologically characterized by diffuse alveolar damage (DAD), and its pathological findings have been reported to be associated with prognosis, although the adverse effects of lung biopsies to obtain pathological findings are still unclear. The purpose of this systematic review and meta-analysis is to reveal the safety and feasibility of lung biopsy in the diagnosis of ARDS.Methods and analysisWe will include studies that were published in MEDLINE and Cochrane Central Register of Controlled Trials until June 1, 2020. We will include the reports for critically ill patients in an intensive care unit or emergency department who undergo lung biopsy and require a mechanical ventilation. Two review authors will independently scan titles and abstracts of all identified studies. Furthermore, these two authors will read and assess the full text of study reports to identify trials that appeared broadly to address the subject of the review. We will perform a risk of bias assessment using the McMaster Quality Assessment Scale of Harms.Ethics and disseminationThis study will be based on the published data, therefore, it does not require ethical approval. The final results of the study will be published in a peer-reviewed journal.UMIN registration numberUMIN000040650Strengths and limitations of this studyThis protocol complies with the Reporting Items for Systematic Review and Meta-Analysis Protocol guidelines.This systematic review and meta-analysis will assess the safety and feasibility of lung biopsy in patients with ARDS.We will evaluate the risk of bias and report according to the McMaster Quality Assessment Scale of Harms.This review will include the reports about only adult patients with acute respiratory failure.We will plan to exclude non-English databases in this study.

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Safety and feasibility of lung biopsy in diagnosis of acute respiratory distress syndrome: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-043600 ◽

2021 ◽

Vol 11 (2) ◽

pp. e043600

Author(s):

Yosuke Fukuda ◽

Hiroshi Sugimoto ◽

Yoshie Yamada ◽

Hiroyuki Ito ◽

Takeshi Tanaka ◽

...

Keyword(s):

Systematic Review ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Lung Biopsy ◽

Distress Syndrome ◽

Meta Analysis ◽

Published Data ◽

Cochrane Central Register ◽

Pathological Findings

IntroductionAcute respiratory distress syndrome (ARDS) is a type of acute respiratory failure characterised by non-cardiac pulmonary oedema caused by various underlying conditions. ARDS is often pathologically characterised by diffuse alveolar damage, and its pathological findings have been reported to be associated with prognosis, although the adverse effects of lung biopsies to obtain pathological findings are still unclear. The purpose of this systematic review and meta-analysis is to reveal the safety and feasibility of lung biopsy in the diagnosis of ARDS.Methods and analysisWe will include studies that were published in MEDLINE and Cochrane Central Register of Controlled Trials until 1 June 2020. We will include the reports for critically ill patients in an intensive care unit or emergency department who undergo lung biopsy and require a mechanical ventilation. Two review authors will independently scan titles and abstracts of all identified studies. Furthermore, these two authors will read and assess the full text of study reports to identify trials that appeared broadly to address the subject of the review. We will perform a risk of bias assessment using the McMaster Quality Assessment Scale of Harms.Ethics and disseminationThis study will be based on the published data, therefore, it does not require ethical approval. The final results of the study will be published in a peer-reviewed journal.Trial registration numberUMIN000040650.

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Extracorporeal carbon dioxide removal for patients with acute respiratory failure secondary to the acute respiratory distress syndrome: a systematic review

Critical Care ◽

10.1186/cc13875 ◽

2014 ◽

Vol 18 (3) ◽

pp. 222 ◽

Cited By ~ 36

Author(s):

Marianne Fitzgerald ◽

Jonathan Millar ◽

Bronagh Blackwood ◽

Andrew Davies ◽

Stephen J Brett ◽

...

Keyword(s):

Carbon Dioxide ◽

Systematic Review ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Failure ◽

Acute Respiratory Failure ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Carbon Dioxide Removal ◽

Extracorporeal Carbon Dioxide Removal

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Correction to data in: The Presence of Diffuse Alveolar Damage on Open Lung Biopsy Is Associated With Mortality in Patients With Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

CHEST Journal ◽

10.1016/j.chest.2016.08.1454 ◽

2016 ◽

Vol 150 (4) ◽

pp. 988

Keyword(s):

Systematic Review ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Lung Biopsy ◽

Distress Syndrome ◽

Diffuse Alveolar Damage ◽

Meta Analysis ◽

Open Lung Biopsy ◽

Open Lung

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Preference-Based Quality of Life for Critical Care Patients with Acute Respiratory Failure and Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a3445 ◽

2019 ◽

Author(s):

K.A. Barrett ◽

A. Zalucky ◽

B. Sander

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Critical Care ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Failure ◽

Acute Respiratory Failure ◽

Distress Syndrome ◽

Meta Analysis ◽

Critical Care Patients

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Predictive Value of the PaO2/FIO2 Ratio for Mortality in Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-1042756/v1 ◽

2021 ◽

Author(s):

Satoshi Yoshimura ◽

Katsuhiko Hashimoto ◽

Yuji Shono ◽

Takahiro Tamura ◽

Ryo Uchimido ◽

...

Keyword(s):

Systematic Review ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

English Language ◽

Distress Syndrome ◽

Meta Analysis ◽

Risk Of Bias ◽

Bivariate Model ◽

Central Registry

Abstract BackgroundPaO2/FIO2 (P/F) ratio has been used to define the severity of acute respiratory distress syndrome (ARDS) despite the controversy of its clinical utility. This systematic review and meta-analysis (SRMA) aimed to obtain summary estimates of predictive performance of the P/F ratio for predicting mortality in ARDS patients.MethodsWe included a study wherein the study population comprised ARDS patients in anyclinical setting. Medline and Cochrane Central Registry of Controlled Trials were searched for all English language articles. We performed a SRMA on the accuracy of diagnostic prognostic tests using QUADAS-2 tool to evaluate the risk of bias. To pool the results, we applied the bivariate model and obtained summary point estimates of sensitivity and specificity with 95% CIs.ResultsTwenty-eight trials and 38270 patients were included in the meta-analysis. Most of the study settings were in the intensive care units. The overall risk of bias was high. The pooled sensitivity of the P/F ratio in all included studies for a P/F ratio of 100 was 43.6% (95% CI, 36.9-50.5%) and the specificity was 71.1% (95% CI, 66.7-75.1%) and those for a P/F ratio of 200 were 83.2% (95% CI, 78.2-87.2%) and 26.2% (95% CI, 21.2-31.9%). ConclusionThe P/F ratio had high sensitivity and moderate specificity at a P/F ratio of 200 and 100 respectively., which supports the use of the P/F ratio for screening ARDS patients who are at risk of deterioration.Trial registration: The study was registered in UMIN with registration number 000041058.

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Predictive Value of the PaO2/FIO2 Ratio for Mortality in Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-1042756/v2 ◽

2022 ◽

Author(s):

Satoshi Yoshimura ◽

Katsuhiko Hashimoto ◽

Yuji Shono ◽

Takahiro Tamura ◽

Ryo Uchimido ◽

...

Keyword(s):

Systematic Review ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

English Language ◽

Distress Syndrome ◽

Meta Analysis ◽

Risk Of Bias ◽

Bivariate Model ◽

Central Registry

Abstract Background PaO2 /FIO2 (P/F) ratio has been used to define the severity of acute respiratory distress syndrome (ARDS) despite the controversy of its clinical utility. This systematic review and meta-analysis (SRMA) aimed to obtain summary estimates of predictive performance of the P/F ratio for predicting mortality in ARDS patients. Methods We included a study wherein the study population comprised ARDS patients in any clinical setting. Medline and Cochrane Central Registry of Controlled Trials were searched for all English language articles. We performed a SRMA on the accuracy of diagnostic prognostic tests using QUADAS-2 tool to evaluate the risk of bias. To pool the results, we applied the bivariate model and obtained summary point estimates of sensitivity and specificity with 95% CIs. Results Twenty-eight trials and 38270 patients were included in the meta-analysis. Most of the study settings were in the intensive care units. The overall risk of bias was high. The pooled sensitivity of the P/F ratio in all included studies for a P/F ratio of 100 was 43.6% (95% CI, 36.9-50.5%) and the specificity was 71.1% (95% CI, 66.7-75.1%) and those for a P/F ratio of 200 were 83.2% (95% CI, 78.2-87.2%) and 26.2% (95% CI, 21.2-31.9%). Interpretation The P/F ratio had high sensitivity and moderate specificity at a P/F ratio of 200 and 100 respectively, which supports the use of the P/F ratio for screening ARDS patients who are at risk of deterioration.Trial registration: The study was registered in UMIN with registration number 64 000041058.

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