Eur Rev Med Pharmacol Sci 2022; 26 (16): 5835-5843

DOI: 10.26355/eurrev_202208_29523

The effect of driving pressure-guided ventilation strategy on the patients with mechanical ventilation: a meta-analysis of randomized controlled trials

Y. Li, Q. Zhang, N. Liu, X.Y. Tan, H. Yue, M.X. Fang

Department of Critical Care Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. m15921196540@163.com


OBJECTIVE: The aim of this study was to evaluate the effect of driving pressure (DP) guided ventilation strategy on the patients with mechanical ventilation in the hospital.

MATERIALS AND METHODS: The articles published in PubMed, the Cochrane Library, the China National Knowledge Information (CNKI), Wei Pu, Wan Fang database and Web of Science from inception to September 2021 were retrieved. The Q test and the I² statistic were used to assess statistical heterogeneity. Risks ratios (RR) with 95% confidence intervals (CI) were calculated for mortality.

RESULTS: Seven studies (n=1,405 patients) were included. Five studies reported an adjusted Risk Ratio (RR) of mortality. Compared with the control group, the DP guided ventilation group was associated with a decreased mortality (RR 0.56; 95% confidence interval [CI], 0.39-0.79; p=0.001; I2 = 23%) using a fixed-effects model without significant heterogeneity. The control group had significantly higher driving pressure level than DP guided group (MD -3.03, 95%CI, -5.72 – -0.34, I2=100%, p=0.03); PaO2/FiO2 was significantly higher in DP guided group than in control group (MD 43.37; 95%CI, 12.58-74.15; I2=97%, p=0.006). There was no statistically significant difference in respiratory compliance, complications, platform pressure, duration of mechanical ventilation and the length of hospital stay between the DP guided group and the control group.

CONCLUSIONS: The results suggested that the driving pressure guided ventilation strategy could decrease the mortality and increase oxygenation index (OI). However, further high-quality randomized controlled trials (RCTs) are needed to verify the impact of driving pressure on mechanically ventilated patients.

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To cite this article

Y. Li, Q. Zhang, N. Liu, X.Y. Tan, H. Yue, M.X. Fang
The effect of driving pressure-guided ventilation strategy on the patients with mechanical ventilation: a meta-analysis of randomized controlled trials

Eur Rev Med Pharmacol Sci
Year: 2022
Vol. 26 - N. 16
Pages: 5835-5843
DOI: 10.26355/eurrev_202208_29523