Journal of critical care
-
Journal of critical care · Dec 2023
Review Meta AnalysisShort-course versus prolonged-course antibiotic regimens for ventilator-associated pneumonia: A systematic review and meta-analysis of randomized controlled trials.
Current guidelines recommend short-duration antibiotic therapy for non-fermenting gram-negative bacilli (NF-GNB) ventilator-associated pneumonia (VAP) which may be associated with a higher recurrence of pneumonia. In this meta-analysis, we aimed to compare short- versus prolonged-course antibiotic regimens for VAP. ⋯ Low-quality evidence suggests that a short course of antibiotics is associated with a higher recurrence of pneumonia in NF-GNB VAP with no difference in mortality as compared to a prolonged course. For definitive conclusions, large-scale and blinded RCTs are required.
-
Journal of critical care · Dec 2023
Meta AnalysisChoice of creep or maintenance fluid type and their impact on total daily ICU sodium burden in critically ill patients: A systematic review and meta-analysis.
Maintenance and hidden/creep fluids are a major source of fluid and sodium intake in intensive care unit (ICU) patients. Recent research indicates that low versus high sodium content maintenance fluids could decrease fluid and sodium burden. We conducted a systematic review (SR) with meta-analysis to summarize the impact of maintenance fluid choice on total daily sodium in ICU patients. ⋯ Using low sodium content maintenance/creep fluids substantially reduces daily sodium burden in adult ICU patients. Significant knowledge/research gaps exist regarding relevance and safety.
-
Journal of critical care · Dec 2023
Review Meta AnalysisHigh versus low mean arterial pressure targets after out-of-hospital cardiac arrest: A systematic review and meta-analysis of randomized controlled trials.
Targeting a specific mean arterial pressure (MAP) has been evaluated as a treatment strategy after out-of-hospital cardiac arrest (OHCA) resuscitation. However, the current evidence lacks clear guidelines regarding the optimal MAP target after OHCA. ⋯ A high MAP target may reduce ICU stay and mechanical ventilation duration but did not demonstrate improvements in either mortality or favorable neurological recovery. Therefore, the role of high MAP target remains uncertain and requires further RCTs.
-
Journal of critical care · Dec 2023
Review Meta AnalysisEffectiveness of sleep interventions to reduce delirium in critically ill patients: A systematic review and meta-analysis.
To analyze the effectiveness of sleep interventions in reducing the incidence and duration of delirium in the ICU. ⋯ The current evidence suggests that non-pharmacological sleep interventions are not effective in preventing delirium in ICU patients. However, limited by the number and quality of included studies, future well-designed multicenter randomized controlled trials are still needed to validate the results of this study.