Crit Care Resusc
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Review Meta Analysis
Calorie delivery and clinical outcomes in the critically ill: a systematic review and meta-analysis.
To determine the effect of calorie delivery on hospital mortality among critically ill adults receiving enteral nutrition (EN). Secondary outcomes included the effect of calorie delivery on intensive care unit and hospital length of stay (LOS), duration of mechanical ventilation (MV) and incidence of new-onset pneumonia. ⋯ Delivery of increased calories via the enteral route, with or without supplemental PN, was not associated with a survival benefit.
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Review
Informed consent for procedures in the intensive care unit: ethical and practical considerations.
There is increasing interest in procedural consent (informed consent for invasive procedures) in the intensive care unit. We reviewed studies of procedural consent and show that it is not yet routine practice to obtain consent before performing invasive procedures on ICU patients. We considered logistical barriers to procedural consent in the critical care environment and the ethical implications of introducing routine procedural consent to the ICU.
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The medical emergency team (MET) is now common in many hospitals. Apart from early identification and management of patients who are potentially unwell on the ward, the MET may also be involved in end-of-life (EOL) care. It is not known how often METs perform EOL interventions. ⋯ We show that EOL care is commonly delivered during MET calls, and should be emphasised in training for MET members.
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Review Meta Analysis
Effects of non-invasive ventilation on reintubation rate: a systematic review and meta-analysis of randomised studies of patients undergoing cardiothoracic surgery.
To estimate the effect of non-invasive mechanical ventilation (NIV) on the rate of reintubation among patients undergoing cardiothoracic surgery. ⋯ NIV seems to be effective in reducing reintubation rate after cardiothoracic surgery. The results of this meta-analysis should be confirmed by large randomised controlled studies.
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Review Meta Analysis
A meta-analysis of complications and mortality of extracorporeal membrane oxygenation.
To comprehensively assess published peer-reviewed studies related to extracorporeal membrane oxygenation (ECMO), focusing on outcomes and complications of ECMO in adult patients. ⋯ Even with conditions usually associated with a high chance of death, almost 50% of patients receiving ECMO survive up to discharge. Complications are frequent and most often comprise renal failure, pneumonia or sepsis, and bleeding.