Critical care medicine
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Critical care medicine · Apr 2017
Review Meta AnalysisThe Effect of High-Flow Nasal Cannula Oxygen Therapy on Mortality and Intubation Rate in Acute Respiratory Failure: A Systematic Review and Meta-Analysis.
High-flow nasal cannulae are used in adults with or at risk of acute respiratory failure. We conducted a systematic review and meta-analysis to evaluate the evidence for their use in this setting. ⋯ No difference in mortality or intubation was detected in patients with acute respiratory failure treated with high-flow nasal cannulae compared with usual care. High-flow nasal cannulae seem well tolerated by patients. Further large randomized controlled trials are required to evaluate their utility in this setting.
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Critical care medicine · Apr 2017
Review Meta AnalysisDiagnostic Accuracy of Central Venous Catheter Confirmation by Bedside Ultrasound Versus Chest Radiography in Critically Ill Patients: A Systematic Review and Meta-Analysis.
We performed a systematic review and meta-analysis to examine the accuracy of bedside ultrasound for confirmation of central venous catheter position and exclusion of pneumothorax compared with chest radiography. ⋯ Bedside ultrasound is faster than radiography at identifying pneumothorax after central venous catheter insertion. When a central venous catheter malposition exists, bedside ultrasound will identify four out of every five earlier than chest radiography.
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Critical care medicine · Apr 2017
Review Meta AnalysisPredictors of Outcome With Cerebral Autoregulation Monitoring: A Systematic Review and Meta-Analysis.
To compare cerebral autoregulation indices as predictors of patient outcome and their dependence on duration of monitoring. ⋯ Three cerebral autoregulation indices, pressure reactivity index, mean velocity index based on cerebral perfusion pressure, and autoregulation reactivity index were the best outcome predictors for patients with traumatic brain injury. For patients with subarachnoid hemorrhage, autoregulation reactivity index was the only cerebral autoregulation index predictor of Glasgow Outcome Scale. Continuous assessment of cerebral autoregulation predicted outcome better than intermittent monitoring.
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Critical care medicine · Nov 2016
Review Meta AnalysisNeuromuscular Blocking Agents and Neuromuscular Dysfunction Acquired in Critical Illness: A Systematic Review and Meta-Analysis.
The relationship between neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness remains unclear. We examined the association between neuromuscular blocking agents and ICU-acquired weakness, critical illness polyneuropathy, and critical illness myopathy. ⋯ This meta-analysis suggests a modest association between neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness; limitations include studies with a high risk of bias and a disproportionate contribution from studies examining patients for critical illness polyneuropathy/critical illness myopathy and those with severe sepsis/septic shock.
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Critical care medicine · Sep 2016
Review Meta AnalysisDepressive Symptoms After Critical Illness: A Systematic Review and Meta-Analysis.
To synthesize data on prevalence, natural history, risk factors, and post-ICU interventions for depressive symptoms in ICU survivors. ⋯ Clinically important depressive symptoms occurred in approximately one-third of ICU survivors and were persistent through 12-month follow-up. Greater research into treatment is needed for this common and persistent post-ICU morbidity.