Journal of critical care
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Journal of critical care · Dec 2017
Review Meta AnalysisAccuracy of C - Reactive protein as a bacterial infection marker in critically immunosuppressed patients: A systematic review and meta-analysis.
There is a need for a better understanding of the role of C-reactive protein (CRP) as a valid marker for the detection of bacterial infections in critically immunosuppressed patients. A high negative predictive value of CRP is also needed to rule out sepsis and bacterial infections in immunocompetent patients. However, few studies have evaluated the performance of CRP in immunocompromised hosts. The aim of the present study was to evaluate the performance of CRP as a marker of infection in critically immunosuppressed patients. ⋯ CRP appears to be a good screening tool for sepsis in critically immunosuppressed patients. Submitted PROSPERO 2015: CRD42015019329.
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Journal of critical care · Oct 2017
Review Meta AnalysisSystematic review and meta-analysis of renal replacement therapy modalities for acute kidney injury in the intensive care unit.
To compare clinical outcomes among critically ill adults with acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT), intermittent hemodialysis (IHD) or sustained low efficiency dialysis (SLED). ⋯ We did not find a definitive advantage for any RRT modality on short-term patient or kidney survival. Well-designed, adequately-powered trials are needed to better define the role of RRT modalities for treatment of critically ill patients with AKI.
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Journal of critical care · Oct 2017
Review Meta AnalysisTherapeutic effect of beta-blocker in patients with traumatic brain injury: A systematic review and meta-analysis.
β-Blocker exposure has been shown to reduce mortality in traumatic brain injury (TBI); however, the efficacy of β-blockers remains inconclusive. Therefore, a meta-analysis was conducted in this paper to evaluate the safety and efficacy of β-blocker therapy on patients with TBI. ⋯ The meta-analysis demonstrates that β-blockers are effective in lowering mortality in patients with TBI. However, β-blocker therapy has markedly increased the infection rate and requires a longer period of ventilator support, intensive care management as well as length of stay.
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Journal of critical care · Oct 2017
Review Meta AnalysisIntubation using apnoeic oxygenation to prevent desaturation: A systematic review and meta-analysis.
To determine whether or not apnoeic oxygenation reduces the incidence of hypoxaemia during endotracheal intubation. ⋯ In patients whom are being intubated for any indication other than respiratory failure, apnoeic oxygenation at any flow rate 15L or greater is likely to reduce their incidence of desaturation (<90%) and critical desaturation (<80%). However, further high quality RCTs are required given the high degree of heterogeneity in many of the outcomes and subgroup analyses.
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Journal of critical care · Oct 2017
Review Meta AnalysisRespiratory support techniques to avoid desaturation in critically ill patients requiring endotracheal intubation: A systematic review and meta-analysis.
To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation. ⋯ ApOx was significantly associated with higher minimum SpO2 registered during the intubation procedure. Further studies are needed to increase the number of included patients and demonstrate the benefit of ApOx and of other respiratory support methods (e.g. NIV, HFNC).