BMJ open · 2026
Association between invasive mechanical ventilation and acute kidney injury in critically ill patients: a protocol for a systematic review and meta-analysis of randomised controlled trials.
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Kusirisin Prit, Kung Janice Y, Zampieri Fernando G, Hepokoski Mark, Goligher Ewan C, Duquette D'Arcy, Bagshaw Sean M
Аннотация
INTRODUCTION: Invasive mechanical ventilation (IMV) may contribute to the development and progression of acute kidney injury (AKI) in critically ill patients. Given the expanding evidence-base and the immense variation in the association described, particularly following the COVID-19 pandemic era, a rigorous synthesis is warranted. This systematic review and meta-analysis will evaluate this association and identify potential risk-mitigation strategies.
METHODS AND ANALYSIS: We will conduct a comprehensive search of databases, including Ovid MEDLINE, Ovid Embase, CINAHL, Scopus, Web of Science Core Collection and the Cochrane Library, using keywords to capture relevant literature on IMV and AKI. The search will include studies published from database inception through March 2026. Two reviewers will independently screen, select and extract studies using the web-based platform Covidence. Eligible studies will include randomised controlled trials reporting the occurrence of new-onset or worsening AKI following initiation of IMV in adult patients admitted to intensive care units. Studies in which IMV was initiated after the onset of AKI will be excluded. Study quality and risk of bias will be assessed using the Cochrane Risk-of-Bias 2 Tool. The primary outcome will be the proportion of critically ill patients who develop new-onset or worsening AKI after initiation of IMV. Secondary outcomes will include AKI trajectory, use of organ support and length of stay.
ETHICS AND DISSEMINATION: Ethics approval is not required, as this study will synthesise data from previously published studies and will not involve direct contact with human participants. The findings will be disseminated through presentations at academic conferences and publication in a peer-reviewed journal.
PROSPERO REGISTRATION NUMBER: CRD420261303862.
METHODS AND ANALYSIS: We will conduct a comprehensive search of databases, including Ovid MEDLINE, Ovid Embase, CINAHL, Scopus, Web of Science Core Collection and the Cochrane Library, using keywords to capture relevant literature on IMV and AKI. The search will include studies published from database inception through March 2026. Two reviewers will independently screen, select and extract studies using the web-based platform Covidence. Eligible studies will include randomised controlled trials reporting the occurrence of new-onset or worsening AKI following initiation of IMV in adult patients admitted to intensive care units. Studies in which IMV was initiated after the onset of AKI will be excluded. Study quality and risk of bias will be assessed using the Cochrane Risk-of-Bias 2 Tool. The primary outcome will be the proportion of critically ill patients who develop new-onset or worsening AKI after initiation of IMV. Secondary outcomes will include AKI trajectory, use of organ support and length of stay.
ETHICS AND DISSEMINATION: Ethics approval is not required, as this study will synthesise data from previously published studies and will not involve direct contact with human participants. The findings will be disseminated through presentations at academic conferences and publication in a peer-reviewed journal.
PROSPERO REGISTRATION NUMBER: CRD420261303862.