Journal of critical care
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Journal of critical care · Apr 2020
Meta AnalysisKetamine sedation in mechanically ventilated patients: A systematic review and meta-analysis.
Ketamine use as a sedative agent in mechanically ventilated patients is increasing. This systematic review and meta-analysis collates existing literature and quantifies the impact of ketamine in mechanically ventilated patients. ⋯ The data regarding ketamine use in mechanically ventilated patients is limited in terms of quantity, methodological quality, and demonstrated clinical benefit. Ketamine may play a role as a sedative-sparing agent, but may be associated with harm. High-quality studies are needed before widespread adoption of ketamine earlier in the sedation pathway.
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Journal of critical care · Apr 2020
Meta AnalysisOptic nerve sheath diameter measurement for predicting raised intracranial pressure in adult patients with severe traumatic brain injury: A meta-analysis.
To evaluate and compare the diagnostic feasibility of measuring the optic nerve sheath diameter (ONSD), via brain computed tomography (CT) and ocular ultrasonography (US) for prediction of raised intracranial pressure (ICP) in severe traumatic brain injury (TBI) patients. ⋯ Measurement of the ONSD may be a useful method for predicting raised ICP in adult patients with severe TBI.
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Journal of critical care · Apr 2020
Review Meta AnalysisPharmacological interventions to reduce edema following cardiopulmonary bypass: A systematic review and meta-analysis.
To compare the effectiveness of different types of pharmacological agents to reduce organ specific edema following cardiopulmonary bypass (CPB). ⋯ Overall, neutrophil inhibitors and direct modulators of endothelial barrier (PAR1, Tie2 signaling) most effectively reduced edema following CPB, in particular pulmonary edema. Future research should focus on a combination of these strategies to reduce edema and assess the effect on organ function and outcome following CPB.