Medicina intensiva
-
In this review the usual methods applied in systematic reviews and meta-analyses are outlined. The ideal hypothesis for a systematic review should be generated by information not used later in meta-analyses. The selection of studies involves searching in web repertories, and more than one should be consulted. ⋯ Such collection also should be carried out by two researchers on an independent basis. The most common procedures for combining studies with binary outcomes are described (inverse of variance, Mantel-Haenszel, and Peto), illustrating how they can be done using Stata commands. Assessment of heterogeneity and publication bias is also illustrated with the same program.
-
Review Meta Analysis
Levosimendan in patients with cardiogenic shock complicating myocardial infarction: A meta-analysis.
Cardiac shock is the leading cause of death in patients with acute myocardial infarction. The objective of this systematic review and meta-analysis was to evaluate whether levosimendan, compared to any type of control, is associated with improved clinical outcomes in patients with cardiogenic shock complicating myocardial infarction. ⋯ Levosimendan can improve hemodynamic parameters and cardiac function when compared with a control group, with no evidence of benefit in terms of survival.
-
Major burn injury triggers severe oxidative stress, a systemic inflammatory response, and a persistent hypermetabolic and hypercatabolic state with secondary sarcopenia, multiorgan dysfunction, sepsis and an increased mortality risk. Calorie deficit, negative protein balance and antioxidant micronutrient deficiency after thermal injury have been associated to poor clinical outcomes. ⋯ These strategies have been shown to be able to minimize acute malnutrition, as well as modulate the immunoinflammatory response, and improve relevant clinical outcomes in this patient population. The purpose of this updating review is to summarize the most current evidence on metabolic response and nutrition therapy in critically ill burn patients.