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Extravascular lung water levels are associated with mortality: a systematic review and meta-analysis

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dc.contributor.authorGavelli, Francesco
dc.contributor.authorShi, Rui
dc.contributor.authorTeboul , Jean-Louis
dc.contributor.authorAzzolina, Danila
dc.contributor.authorMercado, Pablo
dc.contributor.authorJozwiak, Mathieu
dc.contributor.authorChew, Michelle
dc.contributor.authorHuber, Wolfgang
dc.contributor.authorY Kirov, Mikhail
dc.contributor.authorV Kuzkov, Vsevolod
dc.contributor.authorLahmer, Tobias
dc.contributor.authorMalbrain, Manu
dc.contributor.authorMallat, Jihad
dc.contributor.authorSakka, Samir
dc.contributor.authorTagami, Takashi
dc.contributor.authorPham, Tài
dc.contributor.authorMonnet , Xavier
dc.date.accessioned2023-12-18T14:57:05Z
dc.date.available2023-12-18T14:57:05Z
dc.date.issued2022
dc.description.abstractBackground: The prognostic value of extravascular lung water (EVLW) measured by transpulmonary thermodilution (TPTD) in critically ill patients is debated. We performed a systematic review and meta-analysis of studies assessing the effects of TPTD-estimated EVLW on mortality in critically ill patients. Methods: Cohort studies published in English from Embase, MEDLINE, and the Cochrane Database of Systematic Reviews from 1960 to 1 June 2021 were systematically searched. From eligible studies, the values of the odds ratio (OR) of EVLW as a risk factor for mortality, and the value of EVLW in survivors and non-survivors were extracted. Pooled OR were calculated from available studies. Mean differences and standard deviation of the EVLW between survivors and non-survivors were calculated. A random effects model was computed on the weighted mean differences across the two groups to estimate the pooled size effect. Subgroup analyses were performed to explore the possible sources of heterogeneity. Results: Of the 18 studies included (1296 patients), OR could be extracted from 11 studies including 905 patients (464 survivors vs. 441 non-survivors), and 17 studies reported EVLW values of survivors and non-survivors, including 1246 patients (680 survivors vs. 566 non-survivors). The pooled OR of EVLW for mortality from eleven studies was 1.69 (95% confidence interval (CI) [1.22; 2.34], p < 0.0015). EVLW was significantly lower in survivors than non-survivors, with a mean difference of -4.97 mL/kg (95% CI [-6.54; -3.41], p < 0.001). The results regarding OR and mean differences were consistent in subgroup analyses. Conclusions: The value of EVLW measured by TPTD is associated with mortality in critically ill patients and is significantly higher in non-survivors than in survivors. This finding may also be interpreted as an indirect confirmation of the reliability of TPTD for estimating EVLW at the bedside. Nevertheless, our results should be considered cautiously due to the high risk of bias of many studies included in the meta-analysis and the low rating of certainty of evidence. Trial registration the study protocol was prospectively registered on PROSPERO: CRD42019126985
dc.description.versionVersión Publicada
dc.identifier.citationGavelli F, Shi R, Teboul JL, Azzolina D, Mercado P, Jozwiak M, Chew MS, Huber W, Kirov MY, Kuzkov VV, Lahmer T, Malbrain MLNG, Mallat J, Sakka SG, Tagami T, Pham T, Monnet X. Extravascular lung water levels are associated with mortality: a systematic review and meta-analysis. Crit Care. 2022 Jul 6;26(1):202. doi: 10.1186/s13054-022-04061-6
dc.identifier.citationhttps://doi.org/10.1186/s13054-022-04061-6
dc.identifier.urihttps://repositorio.udd.cl/handle/11447/8206
dc.language.isoen
dc.subjectCritically ill patients
dc.subjectHemodynamic monitoring
dc.subjectLung edema
dc.subjectTranspulmonary thermodilution
dc.titleExtravascular lung water levels are associated with mortality: a systematic review and meta-analysis
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceCritical care : the official journal of the Critical Care Forum
dspace.entity.typePublication
relation.isAuthorOfPublication4e3332b1-7515-4993-8bf0-7a3d87a3a0e4
relation.isAuthorOfPublication.latestForDiscovery4e3332b1-7515-4993-8bf0-7a3d87a3a0e4

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