Effect of antiplatelet therapy on mortality and acute lung injury in critically ill patients: A systematic review and meta-analysis

Divyanshu Mohananey, Jaskaran Sethi, Pedro A. Villablanca, Muhammad S. Ali, Rohit Kumar, Anushka Baruah, Nirmanmoh Bhatia, Sahil Agrawal, Zeeshan Hussain, Fadi E. Shamoun, John T. Augoustides, Harish Ramakrishna

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Aim: Platelet function is intricately linked to the pathophysiology of critical Illness, and some studies have shown that antiplatelet therapy (APT) may decrease mortality and incidence of acute respiratory distress syndrome (ARDS) in these patients. Our objective was to understand the efficacy of APT by conducting a meta-analysis. Materials and Methods: We conducted a meta-analysis using PubMed, Central, Embase, The Cochrane Central Register, the ClinicalTrials.gov Website, and Google Scholar. Studies were included if they investigated critically ill patients receiving antiplatelet therapy and mentioned the outcomes being studied (mortality, duration of hospitalization, ARDS, and need for mechanical ventilation). Results: We found that there was a significant reduction in all-cause mortality in patients on APT compared to control (odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.70-0.97). Both the incidence of acute lung injury/ARDS (OR: 0.67; 95% CI: 0.57-0.78) and need for mechanical ventilation (OR: 0.74; 95% CI: 0.60-0.91) were lower in the antiplatelet group. No significant difference in duration of hospitalization was observed between the two groups (standardized mean difference:-0.02; 95% CI:-0.11-0.07). Conclusion: Our meta-analysis suggests that critically ill patients who are on APT have an improved survival, decreased incidence of ARDS, and decreased need for mechanical ventilation.

Original languageEnglish (US)
Pages (from-to)626-637
Number of pages12
JournalAnnals of cardiac anaesthesia
Volume19
Issue number4
DOIs
StatePublished - Oct 1 2016

Keywords

  • Acute respiratory distress syndrome
  • Antiplatelet therapy
  • Critical illness
  • Meta-analysis
  • Sepsis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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    Mohananey, D., Sethi, J., Villablanca, P. A., Ali, M. S., Kumar, R., Baruah, A., Bhatia, N., Agrawal, S., Hussain, Z., Shamoun, F. E., Augoustides, J. T., & Ramakrishna, H. (2016). Effect of antiplatelet therapy on mortality and acute lung injury in critically ill patients: A systematic review and meta-analysis. Annals of cardiac anaesthesia, 19(4), 626-637. https://doi.org/10.4103/0971-9784.191576