Effect of pulse indicator continous cadiac output monitoring on prognosis of patients with acute respiratory distress syndrome: a meta-analysis

Abstract

Abstract Objective: To assess the effect of Pulse indicator continuous cardiac output (PiCCO) compared to traditional hemodynamic monitoring in patients with acute respiratory distress syndrome (ARDS). Methods: We conducted a meta-analysis of randomized controlled trials (RCTs) published from Jan. 1, 2012 to Oct. 1, 2022 comparing PiCCO to traditional hemodynamic monitoring in patients with ARDS. Results: We identified 9 RCTs and combined data from 747 patients, including 369 patients in the experimental group and 378 patients in the control group. Compared to the control group, patients in experimental group have shorter mechanical ventilation time (MD: -3.91, 95% CI [-4.91, -2.92], P＜0.00001, random effects model) and length of ICU stay (MD: -5.23, 95% CI [-6.64, -3.82], P＜0.00001, random effects model). 28-day mortality were observed lower in patients monitored by PiCCO compared to that in control group (RR: 0.53, 95% CI [0.39, 0.73], P=0.0001, fixed effects model). Conclusions: PiCCO monitoring can effectively reduce the 28-day mortality of ARDS patients, shorten the duration of mechanical ventilation and ICU stay, and has a positive significance for improving the prognosis of ARDS patients.