OLA strategy for ARDS: Its effect on mortality depends on achieved recruitment (PaO2/FiO2) and mechanical power. Systematic review and meta-analysis with meta-regression.

Data de publicació: 05/06/2021 Data Ahead of Print: 05/06/2021

Autors de IIS La Fe

Vicent Modesto Alapont

Autor

Autors aliens a IIS La Fe

Medina Villanueva, A
Del Villar Guerra, P
Camilo, C
Fernandez-Urena, S
Gordo-Vidal, F
Khemani, R

Abstract

The "Open Lung Approach" (OLA), that includes high levels of positive end-expiratory pressure coupled with limited tidal volumes, is considered optimal for adult patients with ARDS. However, many previous meta-analyses have shown only marginal benefits of OLA on mortality but with statistical heterogeneity. It is crucial to identify the most likely moderators of this effect. To determine the effect of OLA strategy on mortality of ventilated ARDS patients. We hypothesized that the degree of recruitment achieved in the control group (PaO 2 /FiO 2 ratio on day 3 of ventilation), and the difference in Mechanical Power (MP) or Driving Pressure (DP) between experimental and control groups will be the most likely sources of heterogeneity.

Dades de la publicació

ISSN/ISSNe:: 2173-5727, 2173-5727
Tipus:: Article
Pàgines:: -
DOI:: 10.1016/j.medin.2021.03.016
PubMed:: 34103170

Documents

No hi ha documents

Mètriques

Filiacions

Modesto I Alapont, V:: 1 PICU, Hospital Universitari i Politècnic La Fe, València, Spain.
Medina Villanueva, A:: 2 PICU, Hospital Universitario Central de Asturias, Oviedo, Spain.
Del Villar Guerra, P:: 3 Department of Pediatrics, Hospital Universitario Rio Hortega, Valladolid, Spain.
Camilo, C:: 4 PICU, Hospital de Santa Maria-Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
Fernandez-Urena, S:: 5 Urgencias Pediátricas, Complejo Hospitalario Universitario Materno Insular Las Palmas, Universidad de Las Palmas, Las Palmas de Gran Canaria, Spain.
Gordo-Vidal, F:: 6 ICU, Hospital del Henares, Grupo de Investigación en Patología Crítica de la Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain.
Khemani, R:: 7 PICU, Children's Hospital Los Angeles, California, USA.

Keywords

Acute Respiratory Distress Syndrome, Estrategia open-lung, Lung recruitment, Mechanical power, Open lung, Positive end-expiratory pressure, Potencia mecánica, Presión positiva teleespiratoria, Reclutamiento pulmonar, Síndrome de distrés respiratorio agudo