{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:50:01Z","timestamp":1788313801242,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,10,8]],"date-time":"2017-10-08T00:00:00Z","timestamp":1507420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>We aimed to assess patient\u2010important benefits and harms of therapeutic bronchoscopy vs. standard of care (no bronchoscopy) in critically ill patients with acute respiratory failure (<jats:styled-content style=\"fixed-case\">ARF<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a systematic review with meta\u2010analysis and trial sequential analysis (<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>) according to the Cochrane Handbook and <jats:styled-content style=\"fixed-case\">GRADE<\/jats:styled-content> methodology, including a predefined protocol (<jats:styled-content style=\"fixed-case\">PROSPERO<\/jats:styled-content> no. <jats:styled-content style=\"fixed-case\">CRD<\/jats:styled-content>42016046235). We included randomized clinical trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s) comparing therapeutic bronchoscopy to standard of care in critically ill patients with <jats:styled-content style=\"fixed-case\">ARF<\/jats:styled-content>. Two reviewers independently assessed trials for inclusion, extracted data and assessed risk of bias. Risk ratios (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>) with 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) were estimated by conventional meta\u2010analysis. The risk of random errors was assessed by <jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>. Exclusively patient\u2010important outcomes were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included five trials (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>212); all were judged as having high risk of bias. There was no difference in all\u2010cause mortality between therapeutic bronchoscopy and standard of care (<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content> adjusted <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.39; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.14 to 1.07; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> 0%), and only 3% of the required information size had been accrued. There was no difference in <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> length of stay. A shorter duration of mechanical ventilation was suggested by conventional meta\u2010analysis, however <jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content> highlighted that only 42% of the required information size had been accrued, indicating high risk of random errors. No trials reported data on adverse events, hospital length of stay, quality of life or performance status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The quantity and quality of evidence supporting therapeutic bronchoscopy in critically ill patients with <jats:styled-content style=\"fixed-case\">ARF<\/jats:styled-content> is very low with no firm evidence for benefit or harm.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13000","type":"journal-article","created":{"date-parts":[[2017,10,9]],"date-time":"2017-10-09T04:10:12Z","timestamp":1507522212000},"page":"1240-1252","source":"Crossref","is-referenced-by-count":5,"title":["Therapeutic bronchoscopy vs. standard of care in acute respiratory failure: a systematic review"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9724-9504","authenticated-orcid":false,"given":"K. 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