Effects Of Glucocorticoids On The Mortality Of Adult Patients With Adult Acute Respiratory Distress Syndrome: A Meta-analysis

Objective: To study the relationship between corticosteroid therapy and the mortality of adult patients with acute respiratory distress syndrome(ARDS)by the method of meta-analysis.Methods: Searching PUBMED,EMBASE,OVID,MEDLINE,Cochrane Library,CNKI,WANFANG,CBMdisc and VIP databases for relevant clinical studies in English or Chinese published before December 2017.Screening qualified studies according to the inclusion and exclusion criteria for quality evaluation and data extraction.The mortality and the relationship between glucocorticoid treatment and related side effects in patients with acute respiratory distress syndrome after glucocorticoid treatment were evaluated by meta-analysis using Revman 5.3.The statistical results were expressed in forest plot.Results:16 studies were finally included for meta-analysis which totally contain 1360 patients,we noticed that: There were no significant differences in: 1)the in-hospital mortality(OR=0.76,95% CI(0.47,0.47),Z=1.10,P =0.27).2)the ICU mortality(OR=0.43,95% CI(0.03,0.03),Z=0.62,P= 0.54).3)the risk of nosocomial infection(RR= 1.27,95% CI(0.97,0.97),Z=1.72,P=0.09).4)the risk of hyperglycemia(OR=1.46,95% CI(0.72,0.72),Z=1.05,P=0.89).5)the risk of gastrointestinal bleeding(OR=2.28,95% CI(0.59,8.79),Z=1.20,P= 0.23).Conclusion: Systemic application of glucocorticoid for patients with acute respiratory distress syndrome patients did not reduce the in-hospital mortality and ICU mortality and at the same time did not increase the risk of nosocomial infection,hyperglycemia and gastrointestinal bleeding.