Articles: intensive-care-units.
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The enteral route is commonly utilised to support the nutritional requirements of critically ill patients. However, there is paucity of data guiding clinicians regarding the appropriate method of delivering the prescribed dose. Continuous enteral feeding is commonly used; however, a bolus or intermittent method of administration may provide several advantages such as minimising interruptions. The purpose of this meta-analysis is to compare a continuous versus an intermittent or bolus enteral nutrition administration method. ⋯ The current meta-analysis has not identified any clinically relevant difference in most outcome measures relevant to the care of critically ill patients. However, there is a paucity of high-quality randomised controlled clinical trials to guide this decision. Therefore, clinicians may consider either dosing regimen in the context of the patient's care requirements.
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Minerva anestesiologica · Oct 2022
Meta AnalysisThe effects of exposure to severe hyperoxemia on neurological outcome and mortality after cardiac arrest.
Hyperoxemia during cardiac arrest (CA) may increase chances of successful resuscitation. However, episodes of severe hyperoxemia after intensive care unit admission occurs frequently (up to 60%), and these have been associated with higher mortality in CA patients. The impact of severe hyperoxemia on neurological outcome is more unclear. ⋯ Severe hyperoxemia is associated with worse neurological outcome and lower survival in CA survivors admitted to intensive care unit. Clinical efforts should be made to avoid severe hyperoxemia during at least the first 36 hours after cardiac arrest.
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Journal of critical care · Oct 2022
Review Meta AnalysisSleep assessment in critically ill adults: A systematic review and meta-analysis.
To systematically review sleep evaluation, characterize sleep disruption, and explore effects of sleepdisruption on outcomes in adult ICU patients. ⋯ Sleep in critically ill patients is severely disturbed, and actigraphy and RCSQ seem reliable alternatives to PSG. Future studies should evaluate impact of sleep disruption on outcomes.
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Review Meta Analysis
Outcomes of dexmedetomidine versus propofol sedation in critically ill adults requiring mechanical ventilation: a systematic review and meta-analysis of randomised controlled trials.
Guidelines have recommended the use of dexmedetomidine or propofol for sedation after cardiac surgery, and propofol monotherapy for other patients. Further outcome data are required for these drugs. ⋯ Dexmedetomidine did not significantly impact ICU length of stay compared with propofol, but it significantly reduced the duration of mechanical ventilation and the risk of delirium in cardiac surgical patients. It also significantly increased the risk of bradycardia across ICU patient subsets.
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Journal of critical care · Oct 2022
Meta AnalysisAssociation between timing of intubation and clinical outcomes of critically ill patients: A meta-analysis.
Optimal timing of intubation is controversial. We attempted to investigate the association between timing of intubation and clinical outcomes of critically ill patients. ⋯ Avoiding late intubation may be associated with lower mortality in critically ill patients without COVID-19.