Junqiu Wang1, Xuhui Cong2, Mengrong Miao2, Yitian Yang2, Jiaqiang Zhang2. 1. Journal Editorial Department, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China. 2. Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
Abstract
PURPOSE: There are conflicting results as to the effect of inhaled nitric oxide (iNO) therapy on the risk of acute kidney injury (AKI). The aim of this study was to perform a meta-analysis to assess the updated data. METHODS: We systematically searched Web of Science, the Cochrane Library, Wanfang, and PubMed for relevant randomized control trials between database inception and 9/07/2020. Relative risks (RRs) with 95% confidence intervals (CIs) predicting the risk of AKI were extracted to obtain summary estimates using fixed-effects models. The Trim and Fill method was used to evaluate the sensitivity of the results and adjust for publication bias in meta-analysis. RESULTS: 15 randomized controlled studies from 14 articles involving 1853 patients were included in the study. Analyzing the eligible studies we found: (1) iNO therapy significantly increased the risk of AKI in acute respiratory distress syndrome patients (RR 1.55, 95% CI 1.15-2.10, p = 0.004; I 2 for heterogeneity 0%; P het = 0.649). (2) The use of iNO was associated with reduced AKI risk in patients undergoing cardiac surgery (RR 0.80, 95% CI 0.64-0.99, p = 0.037; I 2 for heterogeneity 0%; P het = 0.528). (3) For organ transplantation recipients, there was no effect of iNO administration on the risk of AKI (RR 0.50, 95% CI 0.16-1.56, p = 0.233; I 2 for heterogeneity 0%; P het = 0.842). The Trim and Fill analysis showed that the overall effect of this meta-analysis was stable. CONCLUSIONS: The effect of iNO on AKI risk might be disease-specific. Future RCTs with larger patient populations should aim to validate our findings.
PURPOSE: There are conflicting results as to the effect of inhaled nitric oxide (iNO) therapy on the risk of acute kidney injury (AKI). The aim of this study was to perform a meta-analysis to assess the updated data. METHODS: We systematically searched Web of Science, the Cochrane Library, Wanfang, and PubMed for relevant randomized control trials between database inception and 9/07/2020. Relative risks (RRs) with 95% confidence intervals (CIs) predicting the risk of AKI were extracted to obtain summary estimates using fixed-effects models. The Trim and Fill method was used to evaluate the sensitivity of the results and adjust for publication bias in meta-analysis. RESULTS: 15 randomized controlled studies from 14 articles involving 1853 patients were included in the study. Analyzing the eligible studies we found: (1) iNO therapy significantly increased the risk of AKI in acute respiratory distress syndromepatients (RR 1.55, 95% CI 1.15-2.10, p = 0.004; I 2 for heterogeneity 0%; P het = 0.649). (2) The use of iNO was associated with reduced AKI risk in patients undergoing cardiac surgery (RR 0.80, 95% CI 0.64-0.99, p = 0.037; I 2 for heterogeneity 0%; P het = 0.528). (3) For organ transplantation recipients, there was no effect of iNO administration on the risk of AKI (RR 0.50, 95% CI 0.16-1.56, p = 0.233; I 2 for heterogeneity 0%; P het = 0.842). The Trim and Fill analysis showed that the overall effect of this meta-analysis was stable. CONCLUSIONS: The effect of iNO on AKI risk might be disease-specific. Future RCTs with larger patient populations should aim to validate our findings.
Authors: Khalid Al Sulaiman; Ghazwa B Korayem; Ali F Altebainawi; Shmeylan Al Harbi; Abdulrahman Alissa; Abdullah Alharthi; Raed Kensara; Amjaad Alfahed; Ramesh Vishwakarma; Hussain Al Haji; Naif Almohaimid; Omar Al Zumai; Fahad Alrubayan; Abdulmajid Asiri; Nasser Alkahtani; Abdulaziz Alolayan; Samiah Alsohimi; Nawal Melibari; Alaa Almagthali; Seba Aljahdali; Abeer A Alenazi; Alawi S Alsaeedi; Ghassan Al Ghamdi; Omar Al Faris; Joud Alqahtani; Jalal Al Qahtani; Khalid A Alshammari; Khalil I Alshammari; Ohoud Aljuhani Journal: Crit Care Date: 2022-10-03 Impact factor: 19.334