Safety and feasibility of lung biopsy in diagnosis of acute respiratory distress syndrome: protocol for a systematic review and meta-analysis

IntroductionAcute respiratory distress syndrome (ARDS) is a type of acute respiratory failure characterized by non-cardiac pulmonary edema caused by various underlying conditions. ARDS is often pathologically characterized by diffuse alveolar damage (DAD), and its pathological findings have been reported to be associated with prognosis, although the adverse effects of lung biopsies to obtain pathological findings are still unclear. The purpose of this systematic review and meta-analysis is to reveal the safety and feasibility of lung biopsy in the diagnosis of ARDS. Methods and analysisWe will include studies that were published in MEDLINE and Cochrane Central Register of Controlled Trials until June 1, 2020. We will include the reports for critically ill patients in an intensive care unit or emergency department who undergo lung biopsy and require a mechanical ventilation. Two review authors will independently scan titles and abstracts of all identified studies. Furthermore, these two authors will read and assess the full text of study reports to identify trials that appeared broadly to address the subject of the review. We will perform a risk of bias assessment using the McMaster Quality Assessment Scale of Harms. Ethics and disseminationThis study will be based on the published data, therefore, it does not require ethical approval. The final results of the study will be published in a peer-reviewed journal. UMIN registration numberUMIN000040650 Strengths and limitations of this studyO_LIThis protocol complies with the Reporting Items for Systematic Review and Meta-Analysis Protocol guidelines. C_LIO_LIThis systematic review and meta-analysis will assess the safety and feasibility of lung biopsy in patients with ARDS. C_LIO_LIWe will evaluate the risk of bias and report according to the McMaster Quality Assessment Scale of Harms. C_LIO_LIThis review will include the reports about only adult patients with acute respiratory failure. C_LIO_LIWe will plan to exclude non-English databases in this study. C_LI