Mortality of right ventricular dysfunction in patients with acute respiratory distress syndrome subjected to lung protective ventilation: A systematic review and meta-analysis

BACKGROUND: The impact of right ventricular dysfunction(RVD) on the prognosis of acute respiratory distress syndrome(ARDS) patients is controversial. OBJECTIVES: The objectives of this systematic review and meta-analysis was to investigate whether RVD or pulmonary vascular dysfunction are associated with increased mortality in patients with ARDS. METHODS: We searched Pubmed, Embase, Cochrane Library, Wanfang Data, CNKI, and the WHO Clinical Trial Registry for studies of RVD or pulmonary vascular dysfunction in patients with ARDS. RESULTS: The presence of RVD or pulmonary vascular dysfunction in patients with ARDS was associated with an increase in mortality (OR = 1.68, 95% CI = 1.21–2.32, P = 0.069, I(2) = 40.8%). Subgroup analyses obtained similar results. Funnel plots and the Egger's test indicated no publication bias, and sensitivity analyses determined that the results were stable. CONCLUSION: The prognosis of patients with ARDS and RVD or pulmonary vascular dysfunction is worse than that of ARDS patients without RVD or pulmonary vascular dysfunction.