Articles: patients.
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Meta Analysis Comparative Study
High-flow nasal cannula oxygen therapy versus noninvasive ventilation in acute respiratory failure related to suspected or confirmed acute heart failure: a systematic review with meta-analysis.
The objective of this review is to compare high-flow nasal cannula (HFNC) oxygen (High flow oxygen) and noninvasive ventilation (NIV) for the management of acute respiratory failure secondary to suspected or confirmed acute heart failure (AHF). A comprehensive and relevant literature search of MEDLINE, Web of Science, and the Cochrane Library was conducted using Medical Subject Heading and Free text terms from January 2010 to March 2024. All randomized clinical trials and observational retrospective and prospective studies reporting adult patients with acute respiratory failure due to suspected or confirmed AHF and comparing HFNC to NIV were included. ⋯ Tracheal intubation requirement was 7% and 5% of patients in the HFNC and NIV groups, respectively (OR: 1.4, 95% CI: 0.5-3.5) in randomized studies, and 20% and 9% in the high flow oxygen and NIV group, respectively (OR: 2.1, 95% CI: 0.5-9.4) in observational studies. Mortality was 13% and 8% in the high flow oxygen and the NIV groups, respectively (OR: 1.8, 95% CI: 0.8-1.1) in randomized studies and 14% and 9% in the high flow oxygen and the NIV groups, respectively (OR: 1.4, 95% CI: 0.5-3.7) in observational studies. Compared with NIV, high flow oxygen was not associated with a higher risk of treatment failure during initial management of patients with acute respiratory failure related to suspected or confirmed AHF.
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Minerva anestesiologica · Dec 2024
Meta Analysis Comparative StudySurvival difference in patients treated with extracorporeal membrane oxygenation in COVID-19 vs. non-COVID ARDS: a systematic review and meta-analysis.
The COVID-19 pandemic has emphasized the need for effective management of severe acute respiratory distress syndrome (ARDS) using veno-venous extracorporeal membrane oxygenation (VV-ECMO). This meta-analysis aims to compare the effectiveness and outcomes of ECMO in patients with COVID-19 ARDS versus those with non-COVID ARDS, assessing its role in different respiratory virus infections. ⋯ ECMO serves as a vital intervention in severe ARDS, with differential effectiveness observed between COVID-19 and non-COVID patients. The study's findings underline the need for precise patient selection and tailored ECMO application across different viral etiologies. These insights are crucial for enhancing clinical strategies and resource allocation during ongoing and future pandemics.
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Minerva anestesiologica · Dec 2024
Meta AnalysisMagnesium sulfate infusion for emergence agitation in adult patients after general anesthesia: a systematic review and meta-analysis of randomized controlled trials.
Emergence agitation following general anesthesia poses significant risks to both patients and medical staff. While extensive research has explored the efficacy of magnesium sulfate (MgSO
4 ) in managing pediatric emergence agitation, its effectiveness in adults remains uncertain. Therefore, this meta-analysis seeks to evaluate the efficacy of MgSO4 in mitigating emergence agitation following general anesthesia in adult populations. ⋯ Magnesium sulfate infusion during general anesthesia was associated with lower incidence of emergence agitation in adults. However, no significant differences were observed regarding emergence agitation severity scores, PONV, or extubation time. -
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously nonalcoholic fatty liver disease (NAFLD), is the number one chronic liver disorder worldwide. Progression to advanced fibrosis marks the emergence of a significant risk of liver-related negative outcomes. However, only a minority of patients will present at this stage. ⋯ As such, research is ongoing. A promising avenue is that of omics, a group of technologies that provide concomitant results on a large number of molecules (and other variables). With the advance of artificial intelligence, new NITs may arise from large demographic, biochemical, and radiological data sets.
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Review
Screening for the Need and Desire for Sexual and Reproductive Health Services: A Systematic Review.
Proactively engaging patients in conversations about their needs and desires for sexual and reproductive health (SRH) is an essential part of providing client-centered care. This systematic literature identifies screening tools and approaches for assessing needs and desires for pregnancy- and STI-related services. ⋯ Screening tools are important for identifying clients' needs and desires as well as informing and streamlining care. More research is needed to better understand the diversity of provider and patient experiences with screening tools and whether the use of such tools promotes accessible and equitable service provision. There was insufficient evidence to recommend any specific screening tool or approach for assessing pregnancy or STI needs and desires because most tools were reported either in a single study or results were mixed.