Abstract:
BACKGROUND:Reduced uterine blood flow from maternal hypotension may contribute to fetal heart rate changes which are common following regional analgesia (epidural or spinal or combined spinal-epidural (CSE)) during labour. Intravenous fluid preloading may help to reduce maternal hypotension but using lower doses of local anaesthetic, and opioid only blocks, may reduce the need for preloading. OBJECTIVES:To assess the effects of prophylactic intravenous fluid preloading before regional analgesia during labour on maternal and fetal well-being. SEARCH STRATEGY:We searched the Cochrane Pregnancy and Childbirth Group trials register (19 February 2004). SELECTION CRITERIA:Randomised and quasi-randomised trials comparing prophylactic intravenous preloading before regional analgesia during labour with a control group (dummy or no preloading). DATA COLLECTION AND ANALYSIS:Two reviewers independently applied eligibility criteria, assessed trial quality and extracted data. MAIN RESULTS:Six studies are included (473 participants). In one epidural trial using high-dose local anaesthetic, preloading with intravenous fluids was shown to counteract the hypotension which frequently follows traditional epidural analgesia (relative risk (RR) 0.07, 95% confidence interval (CI) 0.01 to 0.53; 102 women). This trial was also associated with a reduction in fetal heart rate abnormalities (RR 0.36, 95% CI 0.16 to 0.83; 102 women); no differences were detected in other perinatal and maternal outcomes for this trial and another high-dose epidural trial. In the two epidural low-dose anaesthetic trials, no significant difference in maternal hypotension was found (RR 0.73, 95% CI 0.36 to 1.48; 260 women), although they were underpowered to detect less than a very large effect. No significant differences were seen between groups in these trials for fetal heart rate abnormalities (RR 0.64, 95% CI 0.39 to 1.05; 233 women). In the two CSE trials, no differences were reported between preloading and no preloading groups. In the spinal/opioid trial, the RR for hypotension was 0.89, 95% CI 0.43 to 1.83 (40 women) and 0.70, 95% CI 0.36 to 1.37 for fetal heart rate abnormalities (32 women). In the opioid only study (30 women), there were no instances of hypotension or fetal heart rate abnormalities in either group. REVIEWERS' CONCLUSIONS:Preloading prior to traditional high-dose local anaesthetic blocks may have some beneficial fetal and maternal effects in healthy women. Low-dose epidural and CSE analgesia techniques may reduce the need for preloading. The studies reviewed were too small to show whether preloading is beneficial for women having regional analgesia during labour using the lower-dose local anaesthetics or opioids. Further investigation of low-dose epidural or CSE (including opioid only) blocks, and the risks and benefits of intravenous preloading for women with pregnancy complications, is required.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Hofmeyr G,Cyna A,Middleton Pdoi
10.1002/14651858.CD000175.pub2keywords:
subject
Has Abstractpub_date
2004-10-18 00:00:00pages
CD000175issue
4issn
1469-493Xpub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Potentially disabling postural headache occurs after dural puncture in 1-70% of patients. It has been suggested that such headaches may be less common if patients routinely have a period of bed rest or receive supplementary fluids after the procedure. OBJECTIVES:To assess the effects on post dural puncture ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001790
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Lactoferrin, a normal component of human colostrum and milk, can enhance host defenses and may be effective for prevention of sepsis and necrotizing enterocolitis (NEC) in preterm neonates. OBJECTIVES:Primary objective 1. To assess the safety and effectiveness of lactoferrin supplementation to enteral feeds...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD007137.pub5
更新日期:2017-06-28 00:00:00
abstract:BACKGROUND:Cryptococcal disease remains one of the main causes of death in HIV-positive people who have low cluster of differentiation 4 (CD4) cell counts. Currently, the World Health Organization (WHO) recommends screening HIV-positive people with low CD4 counts for cryptococcal antigenaemia (CrAg), and treating those...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD004773.pub3
更新日期:2018-08-29 00:00:00
abstract:BACKGROUND:Respiratory syncytial virus infection causes acute lung infection in infants and young children worldwide, resulting in considerable morbidity and mortality. Children with cystic fibrosis are prone to recurrent lung inflammation, bacterial colonisation and subsequent chronic airway disease, putting them at r...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD007743.pub6
更新日期:2016-07-20 00:00:00
abstract:BACKGROUND:Antibiotics are frequently prescribed in children. They alter the microbial balance within the gastrointestinal tract, commonly resulting in antibiotic-associated diarrhea (AAD). Probiotics may prevent AAD via restoration of the gut microflora. OBJECTIVES:The primary objectives were to assess the efficacy a...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004827.pub4
更新日期:2015-12-22 00:00:00
abstract:BACKGROUND:A previous meta-analysis investigated the role of chemotherapy in head and neck locally advanced carcinoma. This work had not been performed on nasopharyngeal carcinoma. OBJECTIVES:The aim of the project was to study the effect of adding chemotherapy to radiotherapy on overall survival (OS) and event-free s...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004329.pub2
更新日期:2006-10-18 00:00:00
abstract:BACKGROUND:Chlorpromazine, formulated in the 1950s, remains a benchmark treatment for people with schizophrenia. OBJECTIVES:To evaluate the effects of chlorpromazine for schizophrenia in comparison with placebo. SEARCH STRATEGY:We updated previous searches of the Cochrane Schizophrenia Group Register (October 1999), ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD000284.pub2
更新日期:2007-04-18 00:00:00
abstract:BACKGROUND:Hepatic encephalopathy is a common complication of cirrhosis, with high related morbidity and mortality. Its presence is associated with a wide spectrum of change ranging from clinically obvious neuropsychiatric features, known as 'overt' hepatic encephalopathy, to abnormalities manifest only on psychometric...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD012334.pub2
更新日期:2019-06-17 00:00:00
abstract:BACKGROUND:In the recent years, a variety of bronchoscopic lung volume reduction (BLVR) procedures have emerged that may provide a treatment option to participants suffering from moderate to severe chronic obstructive pulmonary disease (COPD). OBJECTIVES:To assess the effects of BLVR on the short- and long-term health...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD012158.pub2
更新日期:2017-02-23 00:00:00
abstract:BACKGROUND:Haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are related conditions with similar clinical features of variable severity. Survival of patients with HUS and TTP has improved greatly over the past two decades with improved supportive care for patients with HUS and by the use o...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003595.pub2
更新日期:2009-01-21 00:00:00
abstract:BACKGROUND:Percutaneous dilatational tracheostomy (PDT) is one of the most common bedside surgical procedures performed in critically ill adults, on intensive care units (ICUs), who require long-term ventilation. PDT is associated with relevant life-threatening complications: Cuff rupture or accidental extubation may l...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD009901.pub3
更新日期:2018-11-15 00:00:00
abstract:BACKGROUND:Current methods of improving medication adherence for health problems are mostly complex, labour-intensive, and not reliably effective. Medication 'reminder packaging' which incorporates a date or time for a medication to be taken in the packaging, can act as a reminder system to improve adherence. OBJECTIV...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD005025.pub2
更新日期:2006-01-25 00:00:00
abstract:BACKGROUND:People with depression often experience interpersonal problems. Family therapy for depression is a widely used intervention, but it is unclear whether this is an effective therapy for the treatment of depression. OBJECTIVES:To assess the efficacy of family therapy for depression. SEARCH STRATEGY:The follow...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD006728
更新日期:2007-07-18 00:00:00
abstract:BACKGROUND:Evidence from disease epidemics shows that healthcare workers are at risk of developing short- and long-term mental health problems. The World Health Organization (WHO) has warned about the potential negative impact of the COVID-19 crisis on the mental well-being of health and social care professionals. Symp...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD013779
更新日期:2020-11-05 00:00:00
abstract:BACKGROUND:Malignant, or necrotising, otitis externa is a potentially fatal infection of the external ear canal and surrounding soft tissue and bone. It may be complicated by involvement of cranial nerves, principally the facial nerves and the contents of the jugular foramen. It is an uncommon condition mainly found in...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD004617.pub3
更新日期:2013-05-31 00:00:00
abstract:BACKGROUND:Many smokers give up smoking on their own, but materials that provide a structured programme for smokers to follow may increase the number who quit successfully. OBJECTIVES:The aims of this review were to determine the effectiveness of different forms of print-based self-help materials that provide a struct...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析
doi:10.1002/14651858.CD001118.pub4
更新日期:2019-01-09 00:00:00
abstract:BACKGROUND:The risk of maternal mortality and morbidity (particularly postoperative infection) is higher for caesarean section than for vaginal birth. With the increasing rate of caesarean section, it is important that the risks to the mother are minimised as far as possible. This review focuses on different forms and ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD007462.pub3
更新日期:2014-09-17 00:00:00
abstract:BACKGROUND:Surgery has been used as part of breast cancer treatment for centuries; however any surgical procedure has the potential risk of infection. Infection rates for surgical treatment of breast cancer are documented at between 3% and 15%, higher than average for a clean surgical procedure. Pre- and perioperative ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章
doi:10.1002/14651858.CD005360.pub5
更新日期:2019-09-26 00:00:00
abstract:BACKGROUND:Approximately 30% of epilepsy patients remain refractory to drug treatment and continue to experience seizures whilst taking one or more antiepileptic drugs. There are a number of non-pharmacological interventions available to refractory patients which may be used in conjunction with or as an alternative to ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD005502.pub2
更新日期:2007-10-17 00:00:00
abstract:BACKGROUND:Managed withdrawal is a necessary step prior to drug-free treatment or as the end point of substitution treatment. OBJECTIVES:To assess the effectiveness of interventions involving the use of buprenorphine to manage opioid withdrawal, for withdrawal signs and symptoms, completion of withdrawal and adverse e...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD002025.pub4
更新日期:2009-07-08 00:00:00
abstract:BACKGROUND:Alcohol is one of the most common causes of liver disease in the Western World today. Randomised clinical trials have examined the effects of anabolic-androgenic steroids for alcoholic liver disease. OBJECTIVES:The objectives were to assess the beneficial and harmful effects of anabolic-androgenic steroids ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD003045
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Every patient in residential healthcare has a bed. Falling out of bed is associated with preventable patient harm. Various interventions to prevent injury are available. Bed rails are the most common intervention designed to prevent patients falling out of bed; however, their effectiveness is uncertain and b...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008931.pub2
更新日期:2011-11-09 00:00:00
abstract:BACKGROUND:Cervical spinal cord injury (SCI) severely comprises respiratory function due to paralysis and impairment of the respiratory muscles. Various types of respiratory muscle training (RMT) to improve respiratory function for people with cervical SCI have been described in the literature. A systematic review of t...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008507.pub2
更新日期:2013-07-23 00:00:00
abstract:OBJECTIVES:Postpartum education on contraceptive use is a routine component of discharge planning in many different countries with a wide variety of health care systems. This education is based on assumptions concerning women's receptivity to contraceptive education during the postpartum period and their presumed lack ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001863
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Antiviral therapy for recurrent hepatitis C infection after liver transplantation is controversial due to unresolved balance between benefits and harms. OBJECTIVES:To compare the therapeutic benefits and harms of different antiviral regimens in patients with hepatitis C re-infected grafts after liver transp...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD006803.pub4
更新日期:2013-12-04 00:00:00
abstract:BACKGROUND:Randomized trials have demonstrated that adding a drug to a single-agent or to a two-agent regimen increased the tumor response rate in patients with advanced non-small cell lung cancer (NSCLC), although its impact on survival remains controversial. OBJECTIVES:To evaluate the clinical benefit of adding a dr...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004569.pub2
更新日期:2007-10-17 00:00:00
abstract:BACKGROUND:The major modifiable risk factors for necrotising enterocolitis in very low birth weight infants relate to enteral feeding regimens. Observational studies suggest that conservative feeding regimens such as delaying the introduction of enteral feeds or slowly advancing feed volumes reduce the risk of necrotis...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001241.pub2
更新日期:2008-04-16 00:00:00
abstract:BACKGROUND:Foot ulcers in people with diabetes are a prevalent and serious global health issue. Dressings form a key part of ulcer treatment, with clinicians and patients having many different types to choose from including hydrogel dressings. A clear and current overview of current evidence is required to facilitate d...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009101.pub2
更新日期:2011-09-07 00:00:00
abstract:BACKGROUND:It is becoming commonplace for patients to be discharged earlier from acute hospital settings to their own homes and be required to manage various aspects of their own care. This has increased the need for detailed information to be given to patients and/or significant others to enable them to effectively ma...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003716
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:About half of patients with Crohn's disease (CD) require surgery within 10 years of diagnosis. Resection of the affected segment is highly effective, however the majority of patients experience clinical recurrence after surgery. Most of these patients have asymptomatic endoscopic recurrence weeks or months b...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章
doi:10.1002/14651858.CD012328.pub2
更新日期:2020-08-03 00:00:00