Resp Care
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Review Meta Analysis
Diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle biopsy in mediastinal lymphadenopathy: a systematic review and meta-analysis.
To perform a systematic review and meta-analysis of prospectively conducted studies to define diagnostic performance of endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNB) in mediastinal and hilar lymphadenopathy. ⋯ Evidence of moderate quality confirms the high diagnostic performance of EBUS-TBNB for mediastinal and hilar lymphadenopathy, both in malignant and non-malignant conditions. Available evidence also demonstrates the safety of this procedure.
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Review Meta Analysis
Diagnostic accuracy of clinical pulmonary infection score for ventilator-associated pneumonia: a meta-analysis.
To assess the diagnostic accuracy of the clinical pulmonary infection score in the diagnosis of ventilator-associated pneumonia in mechanically ventilated patients. ⋯ The diagnostic performance of the clinical pulmonary infection score for ventilator-associated pneumonia is moderate. However, the clinical pulmonary infection score is simple and easy to perform, and may still be useful in diagnosing ventilator-associated pneumonia.
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Review Meta Analysis
Higher PEEP in patients with acute lung injury: a systematic review and meta-analysis.
Studies of ventilation strategies that included higher PEEP in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) have yielded conflicting results. ⋯ In 4 recent studies that used volume-limited or pressure-limited ventilation in ALI/ARDS patients, higher PEEP was not associated with significantly different short-term mortality or barotrauma. This study does not support the routine use of higher PEEP in patients with ALI/ARDS.
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Meta Analysis
Role of noninvasive ventilation in acute lung injury/acute respiratory distress syndrome: a proportion meta-analysis.
The role of noninvasive ventilation (NIV) in the management of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) is controversial. ⋯ Our results suggest an almost 50% NIV failure rate in patients with ALI/ARDS, so NIV should be cautiously used in patients with ALI/ARDS. There is a need for a uniform NIV protocol for patients with ALI/ARDS.
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Review Meta Analysis
Prevalence of serious bleeding events and intracranial hemorrhage in patients receiving activated protein C: a systematic review and meta-analysis.
Activated protein C reduces 28-day mortality in patients with severe sepsis, but its anticoagulant properties entail a risk of bleeding. ⋯ Activated protein C is associated with significant risk of bleeding, so strict inclusion and exclusion criteria should be set prior to administering activated protein C.