Trial reportLancet (London, England)2012
Effect of intravenous β-2 agonist treatment on clinical outcomes in acute respiratory distress syndrome (BALTI-2): a multicentre, randomised controlled trial.
Trial report in Lancet (London, England), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05075161 (Pirfenidone to Prevent Fibrosis in ARDS. A Randomized Controlled Trial - PIONEER), which is not on this map. Cited by 147 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pirfenidone to Prevent Fibrosis in ARDS. A Randomized Controlled Trial - PIONEER
Who cites it
147 citing papers in PubMed, 12 syntheses or guidelines pooled it, 325 citations in OpenAlex.
- Underreporting of acute kidney injury in randomized trials of acute respiratory distress syndrome with mortality endpoints: a systematic review.Critical care science · 2026Pooled it
- Safety outcomes of salbutamol: A systematic review and meta-analysis.The clinical respiratory journal · 2023Pooled it
- Acute respiratory distress syndrome: potential of therapeutic interventions effective in treating progression from COVID-19 to treat progression from other illnesses-a systematic review.BMJ open respiratory research · 2023Pooled it
- Impact of differences in acute respiratory distress syndrome randomised controlled trial inclusion and exclusion criteria: systematic review and meta-analysis.British journal of anaesthesia · 2021Pooled it
- Between-trial heterogeneity in ARDS research.Intensive care medicine · 2021Pooled it
- Pharmacological agents for adults with acute respiratory distress syndrome.The Cochrane database of systematic reviews · 2019Pooled it
- Inclusion and definition of acute renal dysfunction in critically ill patients in randomized controlled trials: a systematic review.Critical care (London, England) · 2018Pooled it
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.Intensive care medicine · 2017Guideline
- Systematic review and meta-analysis of nasal potential difference in hypoxia-induced lung injury.Scientific reports · 2016Pooled it
- Scandinavian clinical practice guideline on fluid and drug therapy in adults with acute respiratory distress syndrome.Acta anaesthesiologica Scandinavica · 2016Guideline
- Tidal volume and plateau pressure use for acute lung injury from 2000 to present: a systematic literature review.Critical care medicine · 2014Pooled it
- Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012.Intensive care medicine · 2013Guideline
- Plasma matrix metalloproteinase-3 predicts mortality in acute respiratory distress syndrome: a biomarker analysis of a randomized controlled trial.Respiratory research · 2023Trial
- Adrenaline to improve survival in out-of-hospital cardiac arrest: the PARAMEDIC2 RCT.Health technology assessment (Winchester, England) · 2021Trial
- Randomized Clinical Trial of a Combination of an Inhaled Corticosteroid and Beta Agonist in Patients at Risk of Developing the Acute Respiratory Distress Syndrome.Critical care medicine · 2017Trial
- Effects of neuromuscular blockers on transpulmonary pressures in moderate to severe acute respiratory distress syndrome.Intensive care medicine · 2017Trial
- The beta agonist lung injury trial prevention. A randomized controlled trial.American journal of respiratory and critical care medicine · 2014Trial
- A randomized trial of the effects of nebulized albuterol on pulmonary edema in brain-dead organ donors.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2014Trial
- Trial
- Trial
87 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundIn a previous randomised controlled phase 2 trial, intravenous infusion of salbutamol for up to 7 days in patients with acute respiratory distress syndrome (ARDS) reduced extravascular lung water and plateau airway pressure. We assessed the effects of this intervention on mortality in patients with ARDS.
methodsWe did a multicentre, placebo-controlled, parallel-group, randomised trial at 46 UK intensive-care units between December, 2006, and March, 2010. Intubated and mechanically ventilated patients (aged ≥16 years) within 72 h of ARDS onset were randomly assigned to receive either salbutamol (15 μg/kg ideal bodyweight per h) or placebo for up to 7 days. Randomisation was done by a central telephone or web-based randomisation service with minmisation by centre, pressure of arterial oxygen to fractional inspired oxygen concentration (PaO(2)/F(I)O(2)) ratio, and age. All participants, caregivers, and investigators were masked to group allocation. The primary outcome was death within 28 days of randomisation. Analysis was by intention-to-treat. This trial is registered, ISRCTN38366450 and EudraCT number 2006-002647-86.
findingsWe randomly assigned 162 patients to the salbutamol group and 164 to the placebo group. One patient in each group withdrew consent. Recruitment was stopped after the second interim analysis because of safety concerns. Salbutamol increased 28-day mortality (55 [34%] of 161 patients died in the salbutamol group vs 38 (23%) of 163 in the placebo group; risk ratio [RR] 1·47, 95% CI 1·03-2·08).
interpretationTreatment with intravenous salbutamol early in the course of ARDS was poorly tolerated. Treatment is unlikely to be beneficial, and could worsen outcomes. Routine use of β-2 agonist treatment in ventilated patients with this disorder cannot be recommended.
fundingUK Medical Research Council, UK Department of Health, UK Intensive Care Foundation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.