Journal of critical care
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Journal of critical care · Apr 2019
Review Meta AnalysisRecruitment manoeuvres for adults with acute respiratory distress syndrome receiving mechanical ventilation: a systematic review and meta-analysis.
To determine if recruitment manoeuvres (RMs) would decrease 28-day mortality of patients with acute respiratory distress syndrome (ARDS) compared with standard care. ⋯ Earlier meta-analyses found decreased mortality with RMs, in the contrary, our results indicate that RMs could improve oxygenation without detrimental effects, but it does not appear to reduce mortality.
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Journal of critical care · Apr 2019
Review Meta AnalysisEffects of antiplatelet therapy on the mortality rate of patients with sepsis: A meta-analysis.
Abnormal platelet activation plays an important role in the development of sepsis. The effect of antiplatelet drugs on the outcome of patients with sepsis remains unclear. This meta-analysis aimed to determine the effect of antiplatelet drugs on the prognosis of patients with sepsis. ⋯ Antiplatelet drugs, particularly aspirin, could be used to effectively reduce mortality in patients with sepsis.
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Journal of critical care · Apr 2019
Meta AnalysisHigh flow nasal therapy in immunocompromised patients with acute respiratory failure: A systematic review and meta-analysis.
The role of high-flow nasal therapy (HFNT) as compared to conventional oxygen therapy (COT) in immunocompromised patients admitted to intensive care unit (ICU) with acute respiratory failure (ARF) remains unclear. We conducted a systematic review and meta-analysis in order to address this issue. ⋯ We found no benefit of HFNT over COT on mortality in immunocompromised patients with ARF. However, HFNT was associated with a lower intubation rate warranting further research.
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Journal of critical care · Apr 2019
ReviewVentilator-associated pneumonia: The central role of transcolonization.
Ventilator-associated pneumonia remain frequent and serious diseases since they are associated with considerable crude mortality. Pathophysiology is centered on modifications of regional bacterial flora, especially tracheobronchial tree and oropharyngeal sphere. ⋯ Although modification of bacterial flora has been largely studied, the mechanism which underlays the ability of the implantation, growing and interactions with the local microbiome that leads to the observed transcolonization remains to be more clearly deciphered. The aim of our review is to emphasize the cornerstone importance of the "transcolonization" as a nosological entity playing a central role in ventilator-associated pneumonia.
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Journal of critical care · Apr 2019
ReviewThe state of bereavement support in adult intensive care: A systematic review and narrative synthesis.
Despite advances in medical science, patient death and family bereavement are commonly encountered in adult intensive care units (ICUs). This is the first review to investigate the state of ICU bereavement support globally, and the availability and effectiveness of bereavement support interventions. ⋯ The reviewed evidence was weak, and findings were contextually bound. As such, it is difficult to make recommendations for the most acceptable and effective bereavement support intervention(s). Bereavement support in ICU needs further exploration and clinicians must be adequately trained and supported for the delivery of evidence-informed, culturally competent care.