title: Effect of antiplatelet therapy on mortality and acute lung injury in critically ill patients: A systematic review and meta-analysis.
abstract: OBJECTIVE
  Platelet function is intricately linked to the pathophysiology of critical Illness, and some studies have shown that antiplatelet therapy (APT) may decrease mortality and incidence of acute respiratory distress syndrome (ARDS) in these patients. Our objective was to understand the efficacy of APT by conducting a meta-analysis.
  
  
  METHODS
  We conducted a meta-analysis using PubMed, Central, Embase, The Cochrane Central Register, the ClinicalTrials.gov Website, and Google Scholar. Studies were included if they investigated critically ill patients receiving antiplatelet therapy and mentioned the outcomes being studied (mortality, duration of hospitalization, ARDS, and need for mechanical ventilation).
  
  
  RESULTS
  We found that there was a significant reduction in all-cause mortality in patients on APT compared to control (odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.70-0.97). Both the incidence of acute lung injury/ARDS (OR: 0.67; 95% CI: 0.57-0.78) and need for mechanical ventilation (OR: 0.74; 95% CI: 0.60-0.91) were lower in the antiplatelet group. No significant difference in duration of hospitalization was observed between the two groups (standardized mean difference: -0.02; 95% CI: -0.11-0.07).
  
  
  CONCLUSIONS
  Our meta-analysis suggests that critically ill patients who are on APT have an improved survival, decreased incidence of ARDS, and decreased need for mechanical ventilation.
authors.affiliation: Department of Internal Medicine, John H Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, USA.
authors.forename: Divyanshu
authors.initials: D
authors.lastname: Mohananey
authors.affiliation: Department of Internal Medicine, John H Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, USA.
authors.forename: Jaskaran
authors.initials: J
authors.lastname: Sethi
authors.affiliation: Division of Cardiovascular Diseases, Albert Einstein College of Medicine, Montefiore Medical Center, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Villablanca
authors.affiliation: Department of Internal Medicine, John H Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, USA.
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Ali
authors.affiliation: Department of Internal Medicine, John H Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, USA.
authors.forename: Rohit
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Internal Medicine, John H Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, USA.
authors.forename: Anushka
authors.initials: A
authors.lastname: Baruah
authors.affiliation: Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA.
authors.forename: Nirmanmoh
authors.initials: N
authors.lastname: Bhatia
authors.affiliation: Department of Cardiovascular Medicine, St. Lukes University Health Network, Bethlehem, PA 18015, USA.
authors.forename: Sahil
authors.initials: S
authors.lastname: Agrawal
authors.affiliation: Department of Internal Medicine, University of Louisville, Louisville, KY 40292, USA.
authors.forename: Zeeshan
authors.initials: Z
authors.lastname: Hussain
authors.affiliation: Division of Cardiovascular Diseases, 13400 East Mayo Boulevard, Mayo Clinic, Scottsdale, AZ 85259, USA.
authors.forename: Fadi E
authors.initials: FE
authors.lastname: Shamoun
authors.affiliation: Department of Anesthesiology, Hospital of the University of Pennsylvania, 6 Dulles, Philadelphia, PA 19104, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Augoustides
authors.affiliation: Department of Anesthesiology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, USA.
authors.forename: Harish
authors.initials: H
authors.lastname: Ramakrishna
mesh_terms: D055371:Acute Lung Injury / Q000517:prevention & control*; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000401:mortality / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012121:Respiration, Artificial / Q000706:statistics & numerical data
chemical_list: D010975:Platelet Aggregation Inhibitors