Crit Care Resusc
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Meta Analysis
Therapeutic hypothermia and mortality in the intensive care unit: systematic review and meta-analysis.
Therapeutic hypothermia (TH) is defined as the designed reduction of the human body's core temperature to 32°C-35°C for a period of 24-48 hours. TH has been studied extensively in many diseases related to critical care illness. This meta-analysis assesses the effect of TH on mortality across different indications in medical, neurological and cardiothoracic care. ⋯ This meta-analysis suggests that after decades of extensive research, TH has yet to show a beneficial effect on mortality across different critical care diseases.
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Review Meta Analysis
Effect of active temperature management on mortality in intensive care unit patients.
To evaluate the effect of active temperature management on mortality, intensive care unit (ICU) and hospital length of stay, as well as the relative efficacy of antipyretic medications and physical cooling devices for achieving reductions in temperature in critically ill adults. ⋯ Active temperature management neither increased nor decreased mortality risk in critically ill adults. When the therapeutic goal is to reduce body temperature, physical cooling approaches may be more effective than pharmacological measures in critically ill adults.
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Review Meta Analysis Comparative Study
Protein delivery and clinical outcomes in the critically ill: a systematic review and meta-analysis.
Protein is a fundamental component of critical care nutrition, but there has been uncertainty about the optimal amount. We undertook this systematic review and meta-analysis to examine the relationship between delivered protein and mortality in randomised controlled trials (RCTs) of nutritional interventions involving critically ill adults. Secondary outcomes included the effect of protein dose on lengths of stay, mechanical ventilation and incidence of infections. ⋯ Delivery of varying amounts of nutritional protein was not associated with any effect on mortality.
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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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The Crystalloid versus Hydroxyethyl Starch Trial (CHEST) and the Scandinavian Starch in Severe Sepsis/ Septic Shock (6S) trial reported that 6% hydroxyethyl starch (HES) is associated with increased use of renal replacement therapy and death in critically ill patients. Data collection was harmonised between the two trials in order to facilitate a preplanned individual patient data meta-analysis (IPDMA) of patients with severe sepsis. ⋯ We developed a preanalysis SAP to combine data on patients with severe sepsis from the 6S trial and the CHEST. Prepublication of our SAP will reduce the risk of bias in the reporting of the results and improve confidence in the estimates of effects, allowing comparisons with conventional meta-analyses and assisting in the translation of research findings into clinical practice.