Safety, Efficacy, and Clinical Outcomes of APRV in ARDS: A Systematic Review and Meta-Analysis.
Summary
Across nine studies including 1,921 adult ARDS patients, APRV was associated with significantly improved early oxygenation compared with conventional ventilation modes. The review followed PRISMA and used random-effects models, but definitive comparative safety and efficacy conclusions remain limited by heterogeneity.
Key Findings
- Nine studies with 1,921 adult ARDS patients were included.
- APRV significantly improved early oxygenation compared with conventional modes.
- PRISMA-guided methods and random-effects models were used to pool outcomes.
Clinical Implications
APRV can be considered to improve early oxygenation in ARDS, but clinicians should individualize use, monitor for potential harms, and prioritize lung-protective principles until robust RCTs define patient-centered benefits.
Why It Matters
This synthesis consolidates comparative evidence for APRV in ARDS, informing ventilatory strategy choices and highlighting evidence gaps for patient-centered outcomes.
Limitations
- Heterogeneity across included studies may limit definitive conclusions
- Comparative safety and efficacy versus conventional ventilation remain uncertain
Future Directions
Well-powered RCTs with standardized APRV settings and reporting should assess mortality, ventilator-free days, and adverse events to define patient-centered benefits.
Study Information
- Study Type
- Meta-analysis
- Research Domain
- Treatment
- Evidence Level
- I - Quantitative synthesis of comparative studies in adult ARDS following PRISMA guidelines
- Study Design
- OTHER