scholarly journals Interventions to Decrease Mortality Among Patients with Acute Respiratory Distress Syndrome

2021 ◽  
Author(s):  
Emily Cohn
Keyword(s):  
Systematic Review ◽  
Acute Respiratory Distress Syndrome ◽  
Mortality Rate ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Intervention Group ◽  
Flow Diagram ◽  
Cochrane Library ◽  
Meta Analyses

Acute respiratory distress syndrome (ARDS) is a severe complication which affects thousands of patients every year and is associated with high mortality rates and increased healthcare costs. A systematic review was conducted to determine the efficacy of various interventions used to decrease the staggering mortality rate of ARDS. The interventions studied were extracorporeal membrane oxygenation (ECMO), prone positioning, and neuromuscular blockade. Data bases searched were Google Scholar, PubMed, Cochrane library, and the CINAHL databases to find relevant research articles and a literature review conducted. A total of 21 articles were considered and screened for inclusion/exclusion criteria, ultimately yielding five articles included in this systematic review. To guide this major project, the Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and flow diagram were utilized. To further assess the quality of reach study, the Critical Appraisal Skills Programme (CASP) checklist was used. A cross study analysis was performed to compare identified outcomes. This systematic review determined one study to be underpowered, one study demonstrated a decrease in mortality in the intervention group but was not statistically significant, and two studies were stopped for futility. One study was adequately powered and displayed a significant decrease in mortality rate. The results of this systematic review indicates further research is needed on the efficacy of interventions to decrease ARDS-related mortality and guide advanced practice nurse decision-making.

scholarly journals Does Prone Positioning Decrease Mortality Rate in ARDS? A Systematic Review

2018 ◽  
Author(s):  
Joseph Sarkis
Keyword(s):  
Systematic Review ◽  
Acute Respiratory Distress Syndrome ◽  
Mortality Rate ◽  
Respiratory Distress Syndrome ◽  
Supportive Care ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Mortality Rates ◽  
Prone Positioning ◽  
Reduce Mortality Rate

Acute Respiratory Distress Syndrome (ARDS) is a clinical condition in which the lungs suffer severe irreversible, large-scale damage causing a grievous form of hypoxemic respiratory failure. Acute respiratory distress syndrome is one of the most evasive diagnosis confronted in the Intensive care unit (ICU) as the name, definition and diagnostic standards have adapted over the past four decades. An ARDS diagnosis is established by physiological criteria and continues to be a diagnosis of exclusion, which makes it crucial that medical professionals expand their knowledge base to effectively diagnose ARDS. Patients admitted with ARDS have high mortality rates ranging from 40 to 60 percent. High-level quality supportive care continues to be the sole option for ARDS treatment. Even with improved supportive care, however, ARDS prognosis is still poor. Extended prone positioning (PP) has been shown to increase alveolar recruitment end expiratory lung volume, thereby improving oxygenation and survival. Unfortunately, few studies have examined the association of mortality and prone positioning in ARDS. A systematic review was conducted to examine the following research question: Does prone positioning compared to supine positioning in patients with ARDS decrease mortality rates? This systematic review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Critical Appraisal Skills Programme (CASP). A literature review was performed and data were collected from each study. A cross study analysis was performed and PP was found to reduce mortality rate in patients who were severely hypoxic. The reviewed studies demonstrated that incorporating early and longer periods of PP may improve mortality in ARDS patients, but further research is needed.

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.

scholarly journals Effectiveness of Glucocorticoids on acute respiratory distress syndrome: An umbrella review

2020 ◽  
Author(s):  
Semagn Mekonnen ◽  
Haile Mariam Mulugeta Kassim ◽  
Bivash Basu ◽  
Solomon Nega
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Systemic Review ◽  
Cochrane Library ◽  
Umbrella Review ◽  
Quality Of Evidence ◽  
Secondary Outcomes

Abstract Background Management of Acute Respiratory Distress Syndrome is a very challenging critical illness in ICU with high morbidity and mortality worldwide.The review was intended to provide evidence on the effectiveness of Glucocorticoid treatment for acute respiratory distress syndrome Method A comprehensive search strategy was conducted on PubMed/Medline, Cochrane Library, Science direct, LILACS, and African Online Journal. Data extraction was carried out with two independent authors with customized checklist. The quality of each systemic review was assessed by two independent authors using AMSTAR tool and the overall quality of evidence was generated with online GRADEpro GDT software for primary and secondary outcomes. Result The umbrella review included nine systemic reviews and meta-analysis and one narrative review with eight thousand four hundred ninety one participants. The methodological quality of the included studies was moderate to high quality. The overall quality of evidence and recommendation varied form high to very low. Conclusion There is high to moderate quality evidence on the initiation of early low dose prolonged glucocorticoid for reduction of mortality for ARDS. However, randomized controlled trials with large sample sizes to address ventilator-free days, the incidence of infection and other glucocorticoid associated adverse events is required as the quality of evidence with these secondary outcomes were low to very low

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