Medicina intensiva
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Review Meta Analysis
Levosimendan in patients with cardiogenic shock complicating myocardial infarction: A meta-analysis.
Cardiac shock is the leading cause of death in patients with acute myocardial infarction. The objective of this systematic review and meta-analysis was to evaluate whether levosimendan, compared to any type of control, is associated with improved clinical outcomes in patients with cardiogenic shock complicating myocardial infarction. ⋯ Levosimendan can improve hemodynamic parameters and cardiac function when compared with a control group, with no evidence of benefit in terms of survival.
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In this review the usual methods applied in systematic reviews and meta-analyses are outlined. The ideal hypothesis for a systematic review should be generated by information not used later in meta-analyses. The selection of studies involves searching in web repertories, and more than one should be consulted. ⋯ Such collection also should be carried out by two researchers on an independent basis. The most common procedures for combining studies with binary outcomes are described (inverse of variance, Mantel-Haenszel, and Peto), illustrating how they can be done using Stata commands. Assessment of heterogeneity and publication bias is also illustrated with the same program.
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To ascertain the ability of adrenomedullin (ADM) and proadrenomedullin (proADM) to predict mortality in sepsis patients. ⋯ Both ADM and proADM might serve as useful markers for predicting the prognosis of sepsis.
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Multicenter Study Observational Study
Relationship between acute kidney injury and serum procalcitonin (PCT) concentration in critically ill patients with influenza infection.
Serum procalcitonin (PCT) concentration could be increased in patients with renal dysfunction in the absence of bacterial infection. ⋯ Although PCT concentrations were slightly higher in patients with AKI, high PCT concentrations are not explained by AKI and could be warning sign of a potential bacterial infection.