TY - JOUR
T1 - Effect of antiplatelet therapy on mortality and acute lung injury in critically ill patients
T2 - A systematic review and meta-analysis
AU - Mohananey, Divyanshu
AU - Sethi, Jaskaran
AU - Villablanca, Pedro A.
AU - Ali, Muhammad S.
AU - Kumar, Rohit
AU - Baruah, Anushka
AU - Bhatia, Nirmanmoh
AU - Agrawal, Sahil
AU - Hussain, Zeeshan
AU - Shamoun, Fadi E.
AU - Augoustides, John T.
AU - Ramakrishna, Harish
PY - 2016/10/1
Y1 - 2016/10/1
N2 - 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.
AB - 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.
KW - Acute respiratory distress syndrome
KW - Antiplatelet therapy
KW - Critical illness
KW - Meta-analysis
KW - Sepsis
UR - http://www.scopus.com/inward/record.url?scp=84994012266&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84994012266&partnerID=8YFLogxK
U2 - 10.4103/0971-9784.191576
DO - 10.4103/0971-9784.191576
M3 - Article
C2 - 27716693
AN - SCOPUS:84994012266
SN - 0971-9784
VL - 19
SP - 626
EP - 637
JO - Annals of cardiac anaesthesia
JF - Annals of cardiac anaesthesia
IS - 4
ER -