Journal of critical care
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Journal of critical care · Feb 2017
Review Meta AnalysisRole of statins in delirium prevention in critical ill and cardiac surgery patients: A systematic review and meta-analysis.
The data evaluating the role of statins in delirium prevention in the intensive care unit are conflicting and limited. ⋯ In critically ill and cardiac surgery patients, this meta-analysis did not show a benefit with statin therapy in the prevention of delirium.
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Journal of critical care · Feb 2017
Meta AnalysisThe effect of vasoactive drugs on mortality in patients with severe sepsis and septic shock. A network meta-analysis of randomized trials.
Inotropes and vasopressors are cornerstone of therapy in septic shock, but search for the best agent is ongoing. We aimed to determine which vasoactive drug is associated with the best survival. ⋯ Among several regimens for pharmacological cardiovascular support in septic patients, regimens based on inodilators have the highest probability of improve survival.
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Journal of critical care · Feb 2017
Meta AnalysisImproved rule-out diagnostic gain with a combined aortic dissection detection risk score and D-dimer Bayesian decision support scheme.
The objective of this study was to develop a Bayesian clinical decision support mathematical model that can assist in assessing a diagnostic utility integrating the aortic dissection detection risk score (ADD-RS) combined with the diagnostic quality of D-dimer testing.
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Journal of critical care · Oct 2016
Review Meta AnalysisHow safe is gelatin? A systematic review and meta-analysis of gelatin-containing plasma expanders vs crystalloids and albumin.
Gelatin is a widely used synthetic colloid resuscitation fluid. We undertook a systematic review and meta-analysis of adverse effects in randomized and nonrandomized studies comparing gelatin with crystalloid or albumin for treatment of hypovolemia. Multiple databases were searched systematically without language restrictions until August 2015. ⋯ The mean crystalloid-to-colloid ratio was 1.4. Gelatin solutions increase the risk of anaphylaxis and may be harmful by increasing mortality, renal failure, and bleeding possibly due to extravascular uptake and coagulation impairment. Until well-designed randomized controlled trials show that gelatin is safe, we caution against the use of gelatins because cheaper and safer fluid alternatives are available.
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Journal of critical care · Oct 2016
Review Meta Analysis Comparative StudyComparison of high-flow nasal oxygen therapy with conventional oxygen therapy and noninvasive ventilation in adult patients with acute hypoxemic respiratory failure: A meta-analysis and systematic review.
The role of high-flow nasal oxygen (HFNO) therapy in adult patients with acute hypoxemic respiratory failure is controversial. ⋯ High-flow nasal oxygen does not offer any benefit over NIV or conventional oxygen therapy in terms of requirement of higher respiratory support.