PT - JOURNAL ARTICLE AU - Balwinder Singh AU - Akhilesh Kumar Tiwari AU - Kuljit Singh AU - Shannon K Mommer AU - Adil Ahmed AU - Patricia J Erwin; AU - Pablo Moreno Franco TI - BETA-2-AGONIST FOR THE TREATMENT OF ACUTE LUNG INJURY: A SYSTEMATIC REVIEW AND META-ANALYSIS AID - 10.4187/respcare.02571 DP - 2013 Jun 18 TA - Respiratory Care PG - respcare.02571 4099 - http://rc.rcjournal.com/content/early/2013/06/18/respcare.02571.short 4100 - http://rc.rcjournal.com/content/early/2013/06/18/respcare.02571.full AB - Background: The use of beta-2 agonist as an intervention for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) patients is controversial. Therefore, we performed a systematic review and meta-analysis of the published randomized controlled trials (RCT) using beta (β)-2-agonists to improve outcomes (mortality and ventilator free days) among patients with ALI/ARDS. Methods: A comprehensive search of seven major databases (Ovid Medline In-Process and other non-Indexed citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials (CENTRAL), Ovid Cochrane Database of Systematic Reviews, Web of Science, and Scopus) for RCTs using β2-agonists for ALI from their origin to March 2013 was conducted. The effect size was measured by relative-risk (RR) for dichotomous outcomes and mean-difference (MD) for continuous outcomes, with 95% confidence interval (CI). The statistical heterogeneity between the studies was assessed with the Cochran’s Q test and I2 statistic. The heterogeneity of >50% was considered significant for the analysis. Data analyses were performed using Review Manager Version 5.1. The Cochrane risk of bias tool was used to ascertain the quality of the included studies. Results: Out of 219 studies screened, three RCTs reported mortality and ventilator-free days in 646 ALI/ARDS patients. Of the 646 patients, 334 (51.7%) received β2-agonist and 312 (48.3%) received placebo. There was no significant decrease in 28-days and hospital mortality in the β2-agonist group, RR (95% CI) were 1.04(0.50-2.16) and 1.22(0.95-1.56) respectively. The ventilator-free days and organ failure-free days were significantly lower for the ALI patients who received β2-agonists, MD= -2.19 days (95% CI=-3.68 to -1.99) and MD= -2.04 (95%CI= -3.74 to -0.35), respectively. Conclusions: In patients with ALI/ARDS, β2-agonists were not only non-beneficial in improving the survival, but were harmful and increased morbidity (reduced organ-failure free days and ventilator-free days).. The current evidence discourages the use of β2-agonist among ALI/ARDS patients.