Respiratory failure & ventilation
Interventions with a significant mortality difference in acute respiratory distress syndrome: A systematic review and comparison with Guidelines
Authors' conclusion
This systematic review highlights potential gaps between RCTs results and Guidelines that could be used to plan future research or highlight topics to be discussed in future Guidelines.
Study context
- Population
- Patients with acute respiratory distress syndrome (ARDS) in randomized controlled trials (RCTs) reporting a statistically significant mortality difference33 RCTs
- Comparison
- RCT results on mortality vs European Society of Intensive Care Medicine (ESICM) and American Thoracic Society (ATS) Guidelines recommendations
- Outcome
- Interventions with mortality difference in ARDS
Pooled result
As reported in the abstract
- Interventions with mortality difference
- 23
- Invasive ventilation strategies
- 7
- Noninvasive ventilation strategies
- 2
- Extracorporeal membrane oxygenation (ECMO)
- 1
- Drugs
- 12
- Nutritional support
- 1
- RCTs with mortality reduction
- 25/33 (76%)
- RCTs with mortality increase
- 8/33 (24%)
- Interventions not mentioned by Guidelines with reduced mortality
- 8
- Further interventions not mentioned by Guidelines with increased mortality
- 5
Further pooled results
Trial characteristics
- Multicenter studies
- 24/33 (73%)
- Blinded studies
- 19/33 (58%)
Original publication
Interventions with a significant mortality difference in acute respiratory distress syndrome: A systematic review and comparison with Guidelines. J Crit Care. Published 11 August 2026. doi:10.
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