Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2006
Review Meta AnalysisInhaled nitric oxide for respiratory failure in preterm infants.
Inhaled nitric oxide has been proven effective in term infants with hypoxic respiratory failure. The pathophysiology of respiratory failure, and the potential risks, differ substantially in preterm infants. Analysis of the efficacy and toxicities of inhaled nitric oxide in infants born before 35 weeks is therefore necessary. ⋯ The currently published evidence from randomised trials does not support the use of inhaled nitric oxide in preterm infants with hypoxic respiratory failure. Further studies may need to be performed to evaluate the potential benefit of routine use of this therapy in infants with milder forms of respiratory failure, and these trials will need to be designed to evaluate not only neonatal survival, and the occurrence of neonatal morbidities, but should be powered to evaluate neurodevelopmental outcome at a minimum of two years of age.
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Cochrane Db Syst Rev · Jan 2006
Review Meta AnalysisPreoperative hair removal to reduce surgical site infection.
The preparation of people for surgery has traditionally included the routine removal of body hair from the intended surgical wound site. However, there are studies which claim that pre-operative hair removal is deleterious to patients, perhaps by causing surgical site infections (SSIs), and should not be carried out. ⋯ The evidence finds no difference in SSIs among patients who have had hair removed prior to surgery and those who have not. If it is necessary to remove hair then clipping results in fewer SSIs than shaving using a razor. There is insufficient evidence regarding depilatory cream compared with shaving using a razor. There is no difference in SSIs when patients are shaved or clipped one day before surgery or on the day of surgery.
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Cochrane Db Syst Rev · Jan 2006
Review Meta AnalysisContinuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour.
Cardiotocography (sometimes known as electronic fetal monitoring), records changes in the fetal heart rate and their temporal relationship to uterine contractions. The aim is to identify babies who may be short of oxygen (hypoxic), so additional assessments of fetal well-being may be used, or the baby delivered by caesarean section or instrumental vaginal birth. ⋯ Continuous cardiotocography during labour is associated with a reduction in neonatal seizures, but no significant differences in cerebral palsy, infant mortality or other standard measures of neonatal well-being. However, continuous cardiotocography was associated with an increase in caesarean sections and instrumental vaginal births. The real challenge is how best to convey this uncertainty to women to enable them to make an informed choice without compromising the normality of labour.
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Low-back pain is a common condition and a substantial economic burden in industrialized societies. A large proportion of patients with chronic low-back pain use complementary and alternative medicine (CAM), visit CAM practitioners, or both. Several herbal medicines have been purported for use in low-back pain. ⋯ Harpagophytum Procumbens, Salix Alba and Capsicum Frutescens seem to reduce pain more than placebo. Additional trials testing these herbal medicines against standard treatments are needed. The quality of reporting in these trials was generally poor. Trialists should refer to the CONSORT statement extension for reporting trials of herbal medicine interventions.
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Cochrane Db Syst Rev · Jan 2006
Review Meta AnalysisEpidural pain relief versus systemic opioid-based pain relief for abdominal aortic surgery.
Epidural analgesia offers greater pain relief compared to systemic opioid-based medications, but its effect on morbidity and mortality is unclear. ⋯ Epidural analgesia provides better pain relief (especially during movement) for up to three postoperative days. It reduces the duration of postoperative tracheal intubation by roughly 20%. The occurrence of prolonged postoperative mechanical ventilation, overall cardiac complication, myocardial infarction, gastric complication and renal complication was also reduced by epidural analgesia, especially thoracic. However, current evidence does not confirm the beneficial effect of epidural analgesia on postoperative mortality and other types of complications.