Articles: mechanical-ventilation.
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Jpen Parenter Enter · Sep 2015
Review Meta AnalysisModulation of Dietary Lipid Composition During Acute Respiratory Distress Syndrome: Systematic Review and Meta-Analysis.
Pharmaconutrition including omega-3 and competitive analogs of omega-6 fatty acids has been used to modulate the inflammatory response during acute respiratory distress syndrome (ARDS). The clinical benefit of this approach when assessed in prospective randomized clinical trials has been inconsistent. We tried to assess the reasons for the conflicting results, including the possible influence of the composition of the control solution. ⋯ Use of enteral pharmaconutrition in patients with ARDS was associated with decreased mortality only when the comparator solution contained a greater amount of lipid than is currently recommended. Hence, there is insufficient evidence to support the use of enteral pharmaconutrition in ARDS.
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Review Meta Analysis Comparative Study
Efficacy of noninvasive ventilation after planned extubation: A systematic review and meta-analysis of randomized controlled trials.
The objective our meta-analysis is to update the evidence on the efficacy of noninvasive ventilation (NIV) compared with conventional oxygen therapy after planned extubation. We did a systematic literature review of database, including Pubmed, EMBASE, and Cochrane. We included randomized controlled trials comparing NIV with conventional oxygen therapy after planned extubation in medical intensive care unit (ICU) in our analysis. ⋯ However, in a mixed medical ICU population, there was no statistical difference of reintubation rate between the two groups (RR, 0.66; 95% CI, 0.25-1.73; I2 = 68%). Our study suggests that use of NIV after planned extubation significantly decreases the reintubation rate in COPD patients and patients at high risk for extubation failure, confirming the findings of previous reviews. There is no difference in the reintubation rate between the two groups in the mixed medical ICU population.
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Review Meta Analysis
Pneumonia prevention to decrease mortality in intensive care unit: a systematic review and meta-analysis.
To determine the strategies of prevention of hospital-acquired pneumonia that reduce mortality in intensive care unit (ICU). ⋯ Selective digestive decontamination with systemic antimicrobial therapy reduced mortality and should be considered in critically ill patients at high risk for death.
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Ultrasound Med Biol · May 2014
Review Meta AnalysisUltrasonographic measurement of the respiratory variation in the inferior vena cava diameter is predictive of fluid responsiveness in critically ill patients: systematic review and meta-analysis.
Respiratory variation in the inferior vena cava (ΔIVC) has been extensively studied with respect to its value in predicting fluid responsiveness, but the results are conflicting. This systematic review was aimed at investigating the diagnostic accuracy of ΔIVC in predicting fluid responsiveness. Databases including Medline, Embase, Scopus and Web of Knowledge were searched from inception to May 2013. ⋯ The diagnostic performance of ΔIVC appeared to be better in patients on mechanical ventilation than in spontaneously breathing patients (DOR: 30.8 vs. 13.2). The pooled area under the receiver operating characteristic curve was 0.84 (95% CI: 0.79-0.89). Our study indicates that ΔIVC measured with point-of-care ultrasonography is of great value in predicting fluid responsiveness, particularly in patients on controlled mechanical ventilation and those resuscitated with colloids.
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Review Meta Analysis
Benefits of early tracheotomy: a meta-analysis based on six observational studies.
Whether early tracheotomy can improve the clinical outcomes of critically ill patients remains controversial. The current study aimed to discuss the potential benefits of early tracheotomy compared to late tracheotomy with meta-analysis of observational studies. ⋯ Our meta-analysis of retrospective observational studies suggests that early tracheotomy performed between days 3 and 7 after intubation had some advantages, including decreased mortality and reduced ICU stay, hospital stay, and mechanical ventilation duration in ICU patients.