Articles: critical-illness.
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Review Meta Analysis
Use of remifentanil as a sedative agent in critically ill adult patients: a meta-analysis.
This meta-analysis examined the benefits of using remifentanil as a sedative agent in critically ill patients. A total of 11 randomised controlled trials, comparing remifentanil with another opioid or hypnotic agent in 1067 critically ill adult patients, were identified from the Cochrane controlled trials register and EMBASE and MEDLINE databases, and subjected to meta-analysis. ⋯ Remifentanil was, however, not associated with a significant reduction in mortality (relative risk 1.01 (95% CI 0.67-1.52); p = 0.96), duration of mechanical ventilation, length of intensive care unit stay, and risk of agitation (relative risk 1.08 (95% CI 0.64-1.82); p = 0.77) when compared to an alternative sedative or analgesic agent. The current evidence does not support the routine use of remifentanil as a sedative agent in critically ill adult patients.
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Review Meta Analysis
Effect of glucose-insulin-potassium infusion on mortality in critical care settings: a systematic review and meta-analysis.
This study seeks to measure the treatment effect of glucose-insulin-potassium (GIK) infusion on mortality in critically ill patients. A systematic review of randomized controlled trials is conducted, comparing GIK treatment with standard care or placebo in critically ill adult patients. The primary outcome variable is mortality. ⋯ No experimental studies of shock or sepsis populations are identified. This meta-analysis finds that there is no mortality benefit to GIK infusion in critically ill patients; however, study populations are limited to acute myocardial infarction and cardiovascular surgery patients. No studies are identified using GIK in patients with septic shock or other forms of circulatory shock, providing an absence of evidence regarding the effect of GIK as a therapy in patients with shock.
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Intensive care medicine · Jul 2009
Review Meta AnalysisThe impact of obesity on outcomes after critical illness: a meta-analysis.
To assess whether obesity is associated with mortality or other adverse intensive care unit (ICU) and post-ICU outcomes. ⋯ Obesity is not associated with increased risk for ICU mortality, but may be associated with lower hospital mortality. There is a critical lack of research on how obesity may affect complications of critical illness and patient long-term outcomes.
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Zhongguo Wei Zhong Bing Ji Jiu Yi Xue · Jun 2009
Meta Analysis[The influence of intensive insulin therapy on the mortality of critically ill patients in intensive care unit: a meta-analysis].
To assess the influence of intensive insulin therapy (IIT), as compared with conventional insulin therapy (CIT), on mortality of critically ill patients in the intensive care unit (ICU) by Meta-analysis. ⋯ IIT tends to lower the mortality rate, infection rate, and complications in critically ill patients in the ICU as compared with CIT. Also with IIT the target blood glucose can be easier reached than CIT. The therapy can improve the quality of life. However, IIT is not as good as CIT in the control of hypoglycemia.
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Review Meta Analysis
Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data.
Hyperglycemia is associated with increased mortality in critically ill patients. Randomized trials of intensive insulin therapy have reported inconsistent effects on mortality and increased rates of severe hypoglycemia. We conducted a meta-analysis to update the totality of evidence regarding the influence of intensive insulin therapy compared with conventional insulin therapy on mortality and severe hypoglycemia in the intensive care unit (ICU). ⋯ Intensive insulin therapy significantly increased the risk of hypoglycemia and conferred no overall mortality benefit among critically ill patients. However, this therapy may be beneficial to patients admitted to a surgical ICU.