Journal of critical care
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Journal of critical care · Oct 2023
Review Meta AnalysisEffects of tracheostomy timing in adult patients receiving mechanical ventilation: A systematic review and network meta-analysis.
We performed a network meta-analysis (NMA) of multiple tracheostomy timings using data from randomized control trials (RCTs) to investigate the impact on patient prognosis. ⋯ Tracheostomy ≤4 days may result in lower short-term mortality than tracheostomy ≥13 days.
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Journal of critical care · Oct 2023
Meta AnalysisEtomidate as an induction agent for endotracheal intubation in critically ill patients: A meta-analysis of randomized trials.
We performed a meta-analysis of randomized controlled trials to evaluate if etomidate impacted mortality in critically ill adults when compared with other induction agents. ⋯ This meta-analysis found a high probability that etomidate increases mortality when used as an induction agent in critically ill patients with a number needed to harm of 31.
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Journal of critical care · Oct 2023
Review Meta AnalysisNebulized colistin as the adjunctive treatment for ventilator-associated pneumonia: A systematic review and meta-analysis.
Nebulized colistin (NC) is a potential therapy for ventilator-associated pneumonia (VAP); however, the clinical efficacy and safety of NC remain unclear. This study investigated whether NC is an effective therapy for patients with VAP. ⋯ NC was associated with better microbiological outcomes but did not result in any remarkable changes in the prognosis of patients with VAP.
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Journal of critical care · Oct 2023
Multicenter Study Observational StudyMajor adverse cardiovascular events (MACE) in patients with severe COVID-19 registered in the ISARIC WHO clinical characterization protocol: A prospective, multinational, observational study.
To determine its cumulative incidence, identify the risk factors associated with Major Adverse Cardiovascular Events (MACE) development, and its impact clinical outcomes. ⋯ Patients with severe COVID-19 frequently develop MACE, which is independently associated with worse clinical outcomes.
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Journal of critical care · Oct 2023
Meta AnalysisaPTT-guided anticoagulation monitoring during ECMO support: A systematic review and meta-analysis.
The initiation of the extracorporeal membrane oxygenation (ECMO) is associated with complex coagulatory and inflammatory processes and consequently needed anticoagulation. Systemic anticoagulation bears an additional risk of serious bleeding, and its monitoring is of immense importance. Therefore, our work aims to analyze the association of anticoagulation monitoring with bleeding during ECMO support. ⋯ The aPTT-guided anticoagulation is still the standard of care in ECMO patients. We did not find strong evidence supporting the aPTT-guided monitoring during ECMO. Based on the weight of the available evidence, further randomized trials are crucial to clarify the best monitoring strategy.