Objective:

To systematically quantify and categorize complications experienced by patients with ARDS, emphasizing the need for standardization in reporting these complications.

Key Findings:

• Significant variability in complication reporting across studies, indicating a need for standardization.
• Only a few complications were consistently reported, including barotrauma, ventilator-associated pneumonia, and acute kidney injury, which are critical for clinical focus.
• Extreme heterogeneity in pooled estimates suggests a lack of a shared conceptual framework for defining complications, impacting clinical interpretation.

Interpretation:

The findings highlight the need for standardization in how complications are defined and reported in ARDS research, which is crucial for improving clinical decision-making and patient outcomes.

Limitations:

• Causality was not investigated in the synthesis of complications, limiting the ability to draw definitive conclusions.
• The study's descriptive nature limits the ability to draw definitive conclusions about the relationships between complications, which may affect future research directions.

Conclusion:

A structured and causally informed approach to complication reporting is necessary to enhance the clinical relevance of findings in ARDS research, underscoring the need for a shared conceptual framework.