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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Intensive+Care
2018 ; 6
(ä): 35
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Recruitment maneuver does not provide any mortality benefit over lung protective
strategy ventilation in adult patients with acute respiratory distress syndrome:
a meta-analysis and systematic review of the randomized controlled trials
#MMPMID29983985
Bhattacharjee S
; Soni KD
; Maitra S
J Intensive Care
2018[]; 6
(ä): 35
PMID29983985
show ga
BACKGROUND: Clinical benefits of recruitment maneuver in ARDS patients are
controversial. A number of previous studies showed possible benefits; a large
recent study reported that recruitment maneuver and PEEP titration may even be
harmful. This meta-analysis was designed to compare the clinical utility of
recruitment maneuver with low tidal volume ventilation in adult patients with
ARDS. METHODS: Randomized controlled trials comparing recruitment maneuver and
lung protective ventilation strategy with lung protective strategy ventilation
protocol alone in adult patients with ARDS has been included in this
meta-analysis. PubMed and Cochrane Central Register of Controlled Trials were
searched from inception to 10 November 2017 to identify potentially eligible
trials. Pooled risk ratio (RR) and standardized mean difference (SMD) were
calculated for binary and continuous variables respectively. RESULTS: Data of
2480 patients from 7 randomized controlled trials have been included in this
meta-analysis and systemic review. Reported mortality at the longest available
follow-up [RR (95% CI) 0.93 (0.80, 1.08); p =?0.33], ICU mortality [RR (95% CI)
0.91 (0.76, 1.10); p =?0.33] and in-hospital mortality [RR (95% CI) 0.95 (0.83,
1.08); p =?0.45] were similar between recruitment maneuver group and standard
lung protective ventilation group. Duration of hospital stay [SMD (95% CI) 0.00
(-?0.09, 0.10); p =?0.92] and duration of ICU stays [SMD (95% CI) 0.05 (-?0.09,
0.19); p =?0.49] were also similar between recruitment maneuver group and
standard lung protective ventilation group. Risk of barotrauma was also similar.
CONCLUSION: Use of recruitment maneuver along with co-interventions such as PEEP
titration does not provide any benefit in terms of mortality, length of ICU, and
hospital stay in ARDS patients.