Journal of critical care
-
Journal of critical care · Feb 2017
Review Meta AnalysisRisk prediction models for mortality in patients with ventilator-associated pneumonia: A systematic review and meta-analysis.
Ventilator-associated pneumonia (VAP) is a common and serious complication in patients requiring mechanical ventilation in the intensive care unit. The aims of this study were to identify models used to predict mortality in VAP patients and to assess their prognostic accuracy. ⋯ We identified 7 models that have been evaluated for their ability to predict mortality in patients with VAP. The models had nearly equal predictive accuracies, although some models are more complex and time consuming.
-
Journal of critical care · Feb 2017
Meta AnalysisThe effect of vasoactive drugs on mortality in patients with severe sepsis and septic shock. A network meta-analysis of randomized trials.
Inotropes and vasopressors are cornerstone of therapy in septic shock, but search for the best agent is ongoing. We aimed to determine which vasoactive drug is associated with the best survival. ⋯ Among several regimens for pharmacological cardiovascular support in septic patients, regimens based on inodilators have the highest probability of improve survival.
-
Journal of critical care · Oct 2016
Review Meta Analysis Comparative StudyComparison of high-flow nasal oxygen therapy with conventional oxygen therapy and noninvasive ventilation in adult patients with acute hypoxemic respiratory failure: A meta-analysis and systematic review.
The role of high-flow nasal oxygen (HFNO) therapy in adult patients with acute hypoxemic respiratory failure is controversial. ⋯ High-flow nasal oxygen does not offer any benefit over NIV or conventional oxygen therapy in terms of requirement of higher respiratory support.
-
Journal of critical care · Oct 2016
Review Meta AnalysisHow safe is gelatin? A systematic review and meta-analysis of gelatin-containing plasma expanders vs crystalloids and albumin.
Gelatin is a widely used synthetic colloid resuscitation fluid. We undertook a systematic review and meta-analysis of adverse effects in randomized and nonrandomized studies comparing gelatin with crystalloid or albumin for treatment of hypovolemia. Multiple databases were searched systematically without language restrictions until August 2015. ⋯ The mean crystalloid-to-colloid ratio was 1.4. Gelatin solutions increase the risk of anaphylaxis and may be harmful by increasing mortality, renal failure, and bleeding possibly due to extravascular uptake and coagulation impairment. Until well-designed randomized controlled trials show that gelatin is safe, we caution against the use of gelatins because cheaper and safer fluid alternatives are available.
-
Journal of critical care · Aug 2016
Review Meta AnalysisEffect of traditional Chinese medicine on intra-abdominal hypertension and abdominal compartment syndrome: A systematic review and Meta-analysis.
Traditional Chinese medicine (TCM) recently become a widely used treatment option for treating intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). However, we still lack large-scale, high-quality, randomized controlled trials (RCTs). The purpose of this systematic review was to evaluate the existing clinical trials and to provide additional specific evidence. ⋯ TCMs seem to be effective for patients with IAH and ACS; however, most of the reviewed trials are of poor quality. Large-scale, high-quality clinical trials are warranted.