Table 2. Summary of Findings for 28-Day Mortality.
| Comparison | No. | Network Risk Ratio (95% CrI) | Anticipated Absolute Effecta | Quality of Evidence | ||
|---|---|---|---|---|---|---|
| Patients | Trials | With Intervention per 1000 | Difference (95% CrI) | |||
| LPV | NA | NA | 1 [Reference] | 401 | NA | NA |
| VV ECMO | 429 | 2 | 0.60 (0.38 to 0.93) | 240 | −161 (−249 to −28) | Moderate |
| HFOV | 1403 | 3 | 1.12 (0.83 to 1.54) | 449 | 48 (−68 to 200) | Low |
| HFOV and prone positioning | NA | Indirect evidence | 0.53 (0.12 to 1.60) | 212 | −188 (−353 to 241) | Very low |
| NMBA | 956 | 5 | 0.79 (0.57 to 1.02) | 318 | −83 (−173 to 8) | High |
| Open lung strategyb | 3452 | 10 | 0.96 (0.77 to 1.14) | 385 | −16 (−92 to 56) | Low |
| INO and RM | NA | Indirect evidence | 0.86 (0.22 to 3.83) | 345 | −56 (−313 to 599) | Very low |
| Prone positioning | 848 | 3 | 0.69 (0.48 to 0.98) | 277 | −124 (−208 to −8) | Low |
| INO | NA | Indirect evidence | 1.48 (0.42 to 6.08) | 593 | 192 (−233 to 599) | Very low |
| VV ECMO | NA | NA | 1 [Reference] | 240 | NA | NA |
| HFOV | NA | Indirect evidence | 1.88 (1.12 to 3.24) | 451 | 211 (29 to 538) | Low |
| HFOV and prone positioning | NA | Indirect evidence | 0.87 (0.19 to 2.90) | 209 | −31 (−194 to 456) | Very low |
| NMBA | NA | Indirect evidence | 1.30 (0.77 to 2.14) | 312 | 72 (−55 to 274) | Very low |
| Open lung strategyb | NA | Indirect evidence | 1.59 (0.99 to 2.56) | 382 | 142 (−2 to 374) | Very low |
| INO and RM | NA | Indirect evidence | 1.43 (0.34 to 6.60) | 343 | 103 (−158 to 640) | Very low |
| Prone positioning | NA | Indirect evidence | 1.15 (0.66 to 2.01) | 276 | 36 (−82 to 242) | Very low |
| INO | NA | Indirect evidence | 2.48 (0.67 to 10.90) | 595 | 355 (−79 to 760)b | Very low |
| HFOV | NA | NA | 1 [Reference] | 435 | NA | NA |
| HFOV and prone positioning | 26 | 1 | 0.47 (0.11 to 1.44) | 204 | −230 (−387 to 191) | Low |
| NMBA | NA | Indirect evidence | 0.70 (0.48 to 1.02) | 304 | −130 (−226 to 9) | Moderate |
| Open lung strategyb | NA | Indirect evidence | 0.85 (0.58 to 1.19) | 370 | −65 (−183 to 83) | Low |
| INO and RM | NA | Indirect evidence | 0.76 (0.18 to 3.50) | 331 | −104 (−357 to 565) | Very low |
| Prone positioning | 26 | 1 | 0.61 (0.39 to 0.95) | 265 | −170 (−265 to −22) | Moderate |
| INO | NA | Indirect evidence | 1.32 (0.35 to 5.51) | 574 | 139 (−283 to 565) | Very low |
| HFOV and prone positioning | NA | NA | 1 [Reference] | 231 | NA | NA |
| NMBA | NA | Indirect evidence | 1.48 (0.45 to 6.63) | 342 | 111 (−127 to 769) | Very low |
| Open lung strategyb | NA | Indirect evidence | 1.80 (0.56 to 8.01) | 416 | 184 (−102 to 769) | Very low |
| INO and RM | NA | Indirect evidence | 1.67 (0.26 to 13.36) | 386 | 155 (−171 to 769) | Very low |
| Prone positioning | 26 | 1 | 1.31 (0.41 to 5.83) | 303 | 72 (−136 to 769) | Low |
| INO | NA | Indirect evidence | 2.93 (0.49 to 21.97) | 677 | 446 (−118 to 769) | Very low |
| NMBA | NA | NA | 1 [Reference] | 314 | NA | NA |
| Open lung strategyb | NA | Indirect evidence | 1.22 (0.90 to 1.72) | 383 | 69 (−31 to 226) | Very low |
| INO and RM | NA | Indirect evidence | 1.10 (0.28 to 5.04) | 345 | 31 (−226 to 686) | Very low |
| Prone positioning | NA | Indirect evidence | 0.88 (0.56 to 1.40) | 276 | 38 (−138 to 126) | Very low |
| INO | NA | Indirect evidence | 1.91 (0.51 to 8.23) | 600 | 286 (−154 to 686) | Very low |
| Open lung strategyb | NA | NA | 1 [Reference] | 403 | NA | NA |
| INO and RM | 17 | 1 | 0.90 (0.24 to 3.91) | 363 | −40 (−306 to 597) | Very low |
| Prone positioning | NA | Indirect evidence | 0.72 (0.48 to 1.11) | 290 | −113 (−210 to 34) | Very low |
| INO | 12 | 1 | 1.55 (0.44 to 6.28) | 625 | 222 (−226 to 597) | Very low |
| INO and RM | NA | NA | 1 [Reference] | 364 | NA | NA |
| Prone positioning | NA | Indirect evidence | 0.80 (0.18 to 3.22) | 291 | −73 (−299 to 636) | Very low |
| INO | 17 | 1 | 1.74 (0.51 to 5.94) | 633 | 269 (−128 to 636) | Very low |
| Prone positioning | NA | NA | 1 [Reference] | 242 | NA | NA |
| INO | NA | Indirect evidence | 2.15 (0.59 to 8.99) | 520 | 278 (−99 to 758) | Very low |
Abbreviations: CrI, credible interval; HFOV, high-frequency oscillatory ventilation; INO, inhaled nitric oxide; LPV, lung protective ventilation; NA, not applicable; NMBA, neuromuscular blockade; RM, recruitment maneuver; VV ECMO, venovenous extracorporeal membrane oxygenation.
a
To compute anticipated absolute effect, risk ratio is less than or equal to 1 divided by event rate in the reference group (ie, 1/average control risk).
b
Open lung strategy using RM and/or higher positive end-expiratory pressure.