High Positive End-Expiratory Pressure and Lung Recruitment in Moderate to Severe Acute Respiratory Distress Syndrome: Does One Size Really Fit All?

Dianti and colleagues (pp. 1300 - 1310) report a Bayesian network meta-analysis of 18 randomized trials in this issue of the Journal, in which they try to figure out the effects of lower and higher PEEP, as well as brief and prolonged lung recruitment maneuvers, on 28-day mortality in patients with...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2022-06, Vol.205 (11), p.1260-1262
Main Authors: Wendel-Garcia, Pedro D, Roche-Campo, Ferran, Buehler, Philipp K
Format: Article
Language:English
Subjects:
Clinical trials
Humans
Lung
Meta-analysis
Mortality
Network Meta-Analysis
Positive-Pressure Respiration
Respiratory diseases
Respiratory distress syndrome
Respiratory Distress Syndrome - therapy
Thorax
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Summary:Dianti and colleagues (pp. 1300 - 1310) report a Bayesian network meta-analysis of 18 randomized trials in this issue of the Journal, in which they try to figure out the effects of lower and higher PEEP, as well as brief and prolonged lung recruitment maneuvers, on 28-day mortality in patients with moderate to severe ARDS (PaO2/FiO2 200 mm Hg) (4). Network meta-analyses combine direct and indirect evidence to compare multiple therapeutic combinations. The pooling of well-conducted head-to-head therapy studies provides direct data. On the other hand, indirect evidence is calculated by modeling "loops" of evidence. To assess the effect of therapy A versus treatment C, studies comparing treatments A and B are joined with trials comparing treatments B and C.
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.202202-0281ED