Dan Med Bull
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Review Meta Analysis
Evidence based evaluation of immuno-coagulatory interventions in critical care.
Cochrane systematic reviews with meta-analyses of randomised trials provide guidance for clinical practice and health-care decision-making. In case of disagreements between research evidence and clinical practice, high quality systematic reviews can facilitate implementation or deimplementation of medical interventions into clinical practice. This applies especially to treatment of critically ill patients where interventions are most often costly and the clinical conditions are associated with high mortality. ⋯ We did not find reliable evidence to support the clinical use of the assessed immuno-coagulatory interventions for general use in critical care based on the available evidence. A large proportion of the trials had serious methodological shortcomings, small number of patients, and short trial duration. The sparse data provided in the included trials may be or may not be promising but is not necessarily evidence of absence of a beneficial or harmful effect, because many of the outcome measures have not been adequately addressed so far. There is an urgent need for several randomised clinical trials with low risk of bias and low risk of random error to evaluate the use of the assessed interventions.