Intensive care medicine
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Intensive care medicine · Nov 2019
Review Meta AnalysisThe effect of systemic corticosteroids on the incidence of gastrointestinal bleeding in critically ill adults: a systematic review with meta-analysis.
To assess the effect of systemic corticosteroids on the incidence of gastrointestinal bleeding in adult critically ill patients. ⋯ We observed an overall low incidence of clinically important gastrointestinal bleeding among adult critically ill patients. Corticosteroids may slightly increase the incidence of clinically important gastrointestinal bleeding, but not bleeding of any severity. Rarity of events, infrequent trial reporting and high risk of bias reduced the quality of evidence.
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Intensive care medicine · Oct 2019
Review Meta AnalysisPredictors of gastrointestinal bleeding in adult ICU patients: a systematic review and meta-analysis.
To systematically identify predictors of gastrointestinal (GI) bleeding in adult intensive care unit (ICU) patients. ⋯ We identified predictors of CIB and overt GI bleeding in adult ICU patients. These findings may be used to identify ICU patients at higher risk of GI bleeding who are most likely to benefit from stress ulcer prophylaxis.
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Intensive care medicine · Aug 2019
Review Meta AnalysisIntensive care unit length of stay is reduced by protocolized family support intervention: a systematic review and meta-analysis.
This study aimed to elucidate the impact of protocolized family support intervention on length of stay (LOS) in the intensive care unit (ICU) through a systematic review and meta-analysis. ⋯ Protocolized family support intervention for enhanced communication and shared decision-making with the family reduced ICU LOS in critically ill patients without impacting mortality.
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Intensive care medicine · Jul 2019
Review Meta AnalysisChanges in critically ill cancer patients' short-term outcome over the last decades: results of systematic review with meta-analysis on individual data.
The number of averted deaths due to therapeutic advances in oncology and hematology is substantial and increasing. Survival of critically ill cancer patients has also improved during the last 2 decades. However, these data stem predominantly from unadjusted analyses. The aim of this study was to assess the impact of ICU admission year on short-term survival of critically ill cancer patients, with special attention on those with neutropenia. ⋯ After adjustment for patient characteristics, severity of illness and clustering, hospital mortality decreased steadily over time in critically ill oncology and hematology patients except for allogeneic stem cell transplant recipients.
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Intensive care medicine · Jun 2019
Review Meta AnalysisVasopressin in septic shock: an individual patient data meta-analysis of randomised controlled trials.
We performed an individual patient data meta-analysis to investigate the possible benefits and harms of vasopressin therapy in adults with septic shock both overall and in pre-defined subgroups. ⋯ Vasopressin therapy in septic shock had no effect on 28-day mortality although the confidence intervals are wide. It appears safe but with a different side effect profile from norepinephrine. The finding on reduced RRT should be interpreted cautiously. Future trials should focus on long-term outcomes in select patient groups as well as incorporating cost effectiveness analyses regarding possible reduced RRT use.