American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Sep 2017
Meta Analysis Comparative StudySeverity of Hypoxemia and Effect of High Frequency Oscillatory Ventilation in ARDS.
High-frequency oscillatory ventilation (HFOV) is theoretically beneficial for lung protection, but the results of clinical trials are inconsistent, with study-level meta-analyses suggesting no significant effect on mortality. ⋯ HFOV increases mortality for most patients with ARDS but may improve survival among patients with severe hypoxemia on conventional mechanical ventilation.
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Am. J. Respir. Crit. Care Med. · Jun 2017
Meta AnalysisEffort To Breathe With Various Spontaneous Breathing Trial Techniques. A Physiological Meta-analysis.
Spontaneous breathing trials (SBTs) are designed to simulate conditions after extubation, and it is essential to understand the physiologic impact of different methods. ⋯ Pressure support reduces respiratory effort compared with T-piece. Continuous positive airway pressure of 0 cm H2O and T-piece more accurately reflect the physiologic conditions after extubation.
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Am. J. Respir. Crit. Care Med. · Feb 2017
Review Meta AnalysisAn Official American Thoracic Society Systematic Review: The Effect of Nighttime Intensivist Staffing on Mortality and Length of Stay among Intensive Care Unit Patients.
Studies of nighttime intensivist staffing have yielded mixed results. ⋯ Notwithstanding limitations of the predominantly observational evidence, our systematic review and meta-analysis suggests nighttime intensivist staffing is not associated with reduced ICU patient mortality. Other outcomes and alternative staffing models should be evaluated to further guide staffing decisions.
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Am. J. Respir. Crit. Care Med. · Sep 2016
Meta Analysis Comparative StudyContinuous versus Intermittent Beta-lactam Infusion in Severe Sepsis: A Meta-analysis of Individual Patient Data From Randomized Trials.
Optimization of β-lactam antibiotic dosing for critically ill patients is an intervention that may improve outcomes in severe sepsis. ⋯ Compared with intermittent dosing, administration of β-lactam antibiotics by continuous infusion in critically ill patients with severe sepsis is associated with decreased hospital mortality.
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Am. J. Respir. Crit. Care Med. · Feb 2016
Meta AnalysisAssessment of Global Incidence and Mortality of Hospital-treated Sepsis - Current Estimates and Limitations.
Reducing the global burden of sepsis, a recognized global health challenge, requires comprehensive data on the incidence and mortality on a global scale. ⋯ Population-level epidemiologic data for sepsis are scarce and nonexistent for low- and middle-income countries. Our analyses underline the urgent need to implement global strategies to measure sepsis morbidity and mortality, particularly in low- and middle-income countries.