Evidence map›Paper›PMID 41526940›Full record

SynthesisRespiratory research2026

Association between thrombocytopenia and development of acute respiratory distress syndrome.

Elpida Charalampaki, Konstantinos Gkirgkiris, David R Price, Eleni Papoutsi, Georgia M Minatsi, Georgia Dimopoulou, Stylianos E Orfanos, Ioanna Dimopoulou, Anastasia Kotanidou, Ilias I Siempos

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Elpida Charalampaki *First Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, National and Kapodistrian University of Athens Medical School, 45-47 Ipsilantou Street, Athens, 10676, Greece.
Konstantinos Gkirgkiris *First Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, National and Kapodistrian University of Athens Medical School, 45-47 Ipsilantou Street, Athens, 10676, Greece.
David R PriceDepartment of Medicine, New York-Presbyterian Hospital-Weill Cornell Medical Center, Weill Cornell Medicine, New York, NY, USA.
Eleni PapoutsiFirst Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, National and Kapodistrian University of Athens Medical School, 45-47 Ipsilantou Street, Athens, 10676, Greece.
Georgia M MinatsiFirst Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, National and Kapodistrian University of Athens Medical School, 45-47 Ipsilantou Street, Athens, 10676, Greece.
Georgia DimopoulouFirst Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, National and Kapodistrian University of Athens Medical School, 45-47 Ipsilantou Street, Athens, 10676, Greece.
Stylianos E OrfanosNational and Kapodistrian University of Athens Medical School, Athens, Greece.
Ioanna DimopoulouFirst Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, National and Kapodistrian University of Athens Medical School, 45-47 Ipsilantou Street, Athens, 10676, Greece.
Anastasia KotanidouFirst Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, National and Kapodistrian University of Athens Medical School, 45-47 Ipsilantou Street, Athens, 10676, Greece.
Ilias I SiemposFirst Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, National and Kapodistrian University of Athens Medical School, 45-47 Ipsilantou Street, Athens, 10676, Greece. isiempos@yahoo.com.

Funding

Hellenic Thoracic Society 2023
6 · The paper itself

Abstract

backgroundGiven that platelets support the integrity of the alveolar-capillary membrane, it is conceivable that thrombocytopenia may be associated with development of acute respiratory distress syndrome (ARDS). Yet, clinical studies confirming such an association are limited. We endeavoured to examine whether thrombocytopenia is independently associated with development of ARDS in critically ill patients.

methodsFirst, we performed a systematic review and meta-analysis of observational studies reporting the number of patients at risk for ARDS with versus without thrombocytopenia who eventually developed ARDS. Next, we performed a secondary analysis using individual patient-level data from three large randomized controlled trials to estimate whether thrombocytopenia (defined as < 100,000 platelets/µL) was independently associated with development of ARDS.

resultsIn the meta-analysis, four observational studies (five cohorts) involving 3666 critically ill patients were included. Patients with versus without thrombocytopenia were more likely to develop ARDS [46.3% versus 33.2%; relative risk 1.41, 95% confidence intervals (CI) 1.23–1.63; p < 0.001]. In the secondary analysis, data from 2927 critically ill patients were analyzed. After adjustment for confounders, including severity of illness, thrombocytopenia was not independently associated with development of ARDS (odds ratio 1.57, 95% CI 0.95–2.60; p = 0.080). The association between platelet count (as a continuous variable) and development of ARDS was non-linear and appeared U-shaped.

conclusionsThrombocytopenia may not be independently associated with development of ARDS after adjustment for important confounders, such as severity of illness. Thrombocytopenia may serve as a marker of severe illness and its association with ARDS may not represent a mechanistic relationship.

Indexed as

Respiratory Distress SyndromeThrombocytopeniaCritical IllnessHumansObservational Studies as TopicPlatelet CountRandomized Controlled Trials as TopicRisk FactorsAcute hypoxemic respiratory failureAcute lung injuryCritical illnessIntensive care unitPlatelets

Identifiers

PMID41526940
PMCPMC12888621

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Registered trials

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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.