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

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.

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

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.

scholarly journals Incidence and Mortality of Acute Respiratory Distress Syndrome in Patients With Burns: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Baoli Wang ◽  
Wei Chenru ◽  
Yong Jiang ◽  
Lunyang Hu ◽  
He Fang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Inhalation Injury ◽  
African Countries ◽  
Incidence And Mortality

Objective: We conducted a systematic review and meta-analysis to comprehensively estimate the incidence and mortality of acute respiratory distress syndrome (ARDS) in overall and subgroups of patients with burns.Data sources: Pubmed, Embase, the Cochrane Library, CINAHL databases, and China National Knowledge Infrastructure database were searched until September 1, 2021.Study selection: Articles that report study data on incidence or mortality of ARDS in patients with burns were selected.Data extraction: Two researchers independently screened the literature, extracted data, and assessed the quality. We performed a meta-analysis of the incidence and mortality of ARDS in patients with burns using a random effects model, which made subgroup analysis according to the study type, inclusion (mechanical ventilation, minimal burn surface), definitions of ARDS, geographic location, mean age, burn severity, and inhalation injury. Primary outcomes were the incidence and mortality of burns patients with ARDS, and secondary outcomes were incidence for different subgroups.Data synthesis: Pooled weighted estimate of the incidence and mortality of ARDS in patients with burns was 0.24 [95% confidence interval (CI)0.2–0.28] and 0.31 [95% CI 0.18−0.44]. Incidences of ARDS were obviously higher in patients on mechanical ventilation (incidence = 0.37), diagnosed by Berlin definition (incidence = 0.35), and with over 50% inhalation injury proportion (incidence = 0.41) than in overall patients with burns. Patients with burns who came from western countries and with inhalation injury have a significantly higher incidence of ARDS compared with those who came from Asian/African countries (0.28 vs. 0.25) and without inhalation injury (0.41 vs. 0.24).Conclusion: This systematic review and meta-analysis revealed that the incidence of ARDS in patients with burns is 24% and that mortality is as high as 31%. The incidence rates are related to mechanical ventilation, location, and inhalation injury. The patients with burns from western countries and with inhalation injury have a significantly higher incidence than patients from Asian/African countries and without inhalation injury.Systematic Review Registration: identifier: CRD42021144888.

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