Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. May 9, 2022; 11(3): 178-191
Published online May 9, 2022. doi: 10.5492/wjccm.v11.i3.178
Diuretic combinations in critically ill patients with respiratory failure: A systematic review and meta-analysis
Jean Maxime Côté, Nadir Goulamhoussen, Blaithin A McMahon, Patrick T Murray
Jean Maxime Côté, Nadir Goulamhoussen, Division of Nephrology, Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montréal H2X0C1, Québec, Canada
Blaithin A McMahon, Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States
Patrick T Murray, Department of Medicine, School of Medicine, University College Dublin, Dublin D078NN, Ireland
Author contributions: Côté JM, Goulamhoussen N, McMahon BA and Murray PT designed the research study and methodology; Côté JM and Goulamhoussen N performed the research and analyzed the data; Côté JM wrote the draft manuscript; all authors reviewed and approved the final manuscript.
Conflict-of-interest statement: No potential conflict of interest relevant to this article was reported.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jean Maxime Côté, FRCP (C), MD, MSc, Consultant Physician, Division of Nephrology, Department of Medicine, Centre Hospitalier de l'Université de Montréal, CHUM 1000 St Denis, Montréal H2X0C1, Québec, Canada. jean-maxime.cote@umontreal.ca
Received: January 12, 2022
Peer-review started: January 12, 2022
First decision: February 8, 2022
Revised: February 11, 2022
Accepted: April 24, 2022
Article in press: April 24, 2022
Published online: May 9, 2022
Processing time: 114 Days and 9.6 Hours
Core Tip

Core Tip: Loop diuretics are a cornerstone treatment to maintain fluid balance in patients with respiratory failure, but resistance is common. In the caveat of a substantial heterogeneity, this meta-analysis shows a significant increase in urine output with negative fluid balance with the combination of loop diuretics plus thiazides compared to loop diuretics alone in patients with respiratory failure. Further trials are required to confirm the safety and efficacy of such interventions in patients with respiratory failure.