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Anne-Sophie Worm Fenger Markus Harboe Olsen Maria Louise Fabritius Christian Gunge Riberholt Kirsten Møller 《Acta anaesthesiologica Scandinavica》2023,67(2):240-247
Background
Hyperglycaemia is common in patients with acute brain injury admitted to an intensive care unit (ICU). Many studies have found associations between development of hyperglycaemia and increased mortality in hospitalised patients. However, the optimal target for blood glucose control is unknown. We want to conduct a systematic review with meta-analysis and trial sequential analysis to explore the beneficial and harmful effects of restrictive versus liberal glucose control on patient outcomes in adults with severe acute brain injury.Methods
We will systematically search medical databases including CENTRAL, Embase, MEDLINE and trial registries. We will search the following websites for ongoing or unpublished trials: http://www.controlled-trials.com/ , http://www.clinicaltrials.gov/ , www.eudraCT.com , http://centerwatch.com/ , The Cochrane Library's CENTRAL, PubMed, EMBASE, Science Citation Index Expanded and CINAHL. Two authors will independently review and select trials and extract data. We will include randomised trials comparing levels of glucose control in our analyses and observational studies will be included to address potential harms. The primary outcomes are defined as all-cause mortality, functional outcome and health-related quality of life. Secondary outcomes include serious adverse events including hypoglycaemia, length of ICU stay and duration of mechanical ventilation, and explorative outcomes including intracranial pressure and infection. Trial Sequential Analysis will be used to investigate the risk of type I error due to repetitive testing and to further explore imprecision. Quality of trials will be evaluated using the Cochrane Risk of Bias tool, and quality of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.Discussion
The results of the systematic review will be disseminated through peer-reviewed publication. With the review, we hope to inform future randomised clinical trials and improve clinical practice. 相似文献4.
J. Ripollés-Melchor C. Aldecoa E. Alday-Muñoz S. del Río A. Batalla E. del-Cojo-Peces R. Uña-Orejón J.L. Muñoz-Rodés J.V. Lorente Á.V. Espinosa C. Ferrando-Ortolà J.L. Jover A. Abad-Gurumeta J.M. Ramírez-Rodríguez A. Abad-Motos 《Revista espa?ola de anestesiología y reanimación》2021,68(7):373-383
BackgroundThe optimal regimen for intravenous administration of intraoperative fluids remains unclear. Our goal was to analyze intraoperative crystalloid volume administration practices and their association with postoperative outcomes.MethodsWe extracted clinical data from two multicenter observational studies including adult patients undergoing colorectal surgery and total hip (THA) and knee arthroplasty (TKA). We analyzed the distribution of intraoperative fluid administration. Regression was performed using a general linear model to determine factors predictive of fluid administration. Patient outcomes and intraoperative crystalloid utilization were summarized for each surgical cohort. Regression models were developed to evaluate associations of high or low intraoperative crystalloid with the likelihood of increased postoperative complications, mainly acute kidney injury (AKI) and hospital length of stay (LOS).Results7,580 patients were included. The average adjusted intraoperative crystalloid infusion rate across all surgeries was to 7.9 (SD 4) mL/kg/h. The regression model strongly favored the type of surgery over other patient predictors. We found that high fluid volume was associated with 40% greater odds ratio (OR 1.40; 95% confidence interval1.01-1.95, p = 0.044) of postoperative complications in patients undergoing THA, while we found no associations for the other types of surgeries, AKI and LOSConclusionsA wide variability was observed in intraoperative crystalloid volume administration; however, this did not affect postoperative outcomes. 相似文献
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Roby Naym U. Packham Tara L. MacDermid Joy C. Carlesso Lisa C. 《Clinical rheumatology》2022,41(10):3159-3168
Clinical Rheumatology - Central sensitization (CS) is a known contributor to chronic pain in people with knee osteoarthritis (KOA) and is commonly measured by psychophysical testing or... 相似文献
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Die Anaesthesiologie - Eine junge Patientin erleidet während der Anlage einer axillären Plexusblockade einen generalisierten Krampfanfall. Die Mechanismen, im Wesentlichen die vermutlich... 相似文献
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Combs Katie Massey Buckley Pamela R. Lain Marion Amanda Drewelow Karen M. Urano Grace Kerns Suzanne E. U. 《Prevention science》2022,23(6):969-981
Prevention Science - As evidence-based interventions (EBIs) become more widely disseminated, fidelity of implementation (FOI) often wanes. This study explores the association between FOI and... 相似文献
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Kippnich M. Kippnich U. Markus C. Dietz S. Braun R. Pierags G. Hack M. Kraus M. Wurmb T. 《Der Anaesthesist》2019,68(7):428-435
Die Anaesthesiologie - Ein wichtiges Werkzeug zur präklinischen Bewältigung eines Massenanfalls von Notfallpatienten ist der Einsatz eines Behandlungsplatzes (BHP). Unter bestimmten... 相似文献