An updated study-level meta-analysis of randomised controlled trials on proning in ARDS and acute lung injury.

Abstract:

INTRODUCTION:In patients with acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS), recent randomised controlled trials (RCTs) showed a consistent trend of mortality reduction with prone ventilation. We updated a meta-analysis on this topic. METHODS:RCTs that compared ventilation of adult patients with ALI/ARDS in prone versus supine position were included in this study-level meta-analysis. Analysis was made by a random-effects model. The effect size on intensive care unit (ICU) mortality was computed in the overall included studies and in two subgroups of studies: those that included all ALI or hypoxemic patients, and those that restricted inclusion to only ARDS patients. A relationship between studies' effect size and daily prone duration was sought with meta-regression. We also computed the effects of prone positioning on major adverse airway complications. RESULTS:Seven RCTs (including 1,675 adult patients, of whom 862 were ventilated in the prone position) were included. The four most recent trials included only ARDS patients, and also applied the longest proning durations and used lung-protective ventilation. The effects of prone positioning differed according to the type of study. Overall, prone ventilation did not reduce ICU mortality (odds ratio = 0.91, 95% confidence interval = 0.75 to 1.2; P = 0.39), but it significantly reduced the ICU mortality in the four recent studies that enrolled only patients with ARDS (odds ratio = 0.71; 95% confidence interval = 0.5 to 0.99; P = 0.048; number needed to treat = 11). Meta-regression on all studies disclosed only a trend to explain effect variation by prone duration (P = 0.06). Prone positioning was not associated with a statistical increase in major airway complications. CONCLUSIONS:Long duration of ventilation in prone position significantly reduces ICU mortality when only ARDS patients are considered.

journal_name

Crit Care

authors

Abroug F,Ouanes-Besbes L,Dachraoui F,Ouanes I,Brochard L

doi

10.1186/cc9403

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

R6

issue

1

eissn

1364-8535

issn

1466-609X

pii

cc9403

journal_volume

15

pub_type

杂志文章,meta分析
  • Bench-to-bedside review: Burn-induced cerebral inflammation--a neglected entity?

    abstract::Severe burn injury remains a major burden on patients and healthcare systems. Following severe burns, the injured tissues mount a local inflammatory response aiming to restore homeostasis. With excessive burn load, the immune response becomes disproportionate and patients may develop an overshooting systemic inflammat...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc7794

    authors: Flierl MA,Stahel PF,Touban BM,Beauchamp KM,Morgan SJ,Smith WR,Ipaktchi KR

    更新日期:2009-01-01 00:00:00

  • Complications of regional citrate anticoagulation: accumulation or overload?

    abstract::Regional citrate anticoagulation (RCA) is now recommended over systemic heparin for continuous renal replacement therapy in patients without contraindications. Its use is likely to increase throughout the world. However, in the absence of citrate blood level monitoring, the diagnosis of citrate accumulation, the most ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-017-1880-1

    authors: Schneider AG,Journois D,Rimmelé T

    更新日期:2017-11-19 00:00:00

  • Intensive care unit acquired muscle weakness: when should we consider rehabilitation?

    abstract::Muscle weakness is highly prevalent during acute critical illness, with the poor exercise performance that occurs after critical illness being recognized as a consequence of skeletal muscles weakness. Advanced techniques to measure peripheral muscle strength are available, but they have limited use in the clinical set...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc7937

    authors: Puthucheary Z,Hart N

    更新日期:2009-01-01 00:00:00

  • The evolving story of medical emergency teams in quality improvement.

    abstract::Adverse events affect approximately 3% to 12% of hospitalized patients. At least a third, but as many as half, of such events are considered preventable. Detection of these events requires investments of time and money. A report in a recent issue of Critical Care used the medical emergency team activation as a trigger...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc8033

    authors: Amaral AC,Shojania KG

    更新日期:2009-01-01 00:00:00

  • Pulse-pressure variation and hemodynamic response in patients with elevated pulmonary artery pressure: a clinical study.

    abstract:INTRODUCTION:Pulse-pressure variation (PPV) due to increased right ventricular afterload and dysfunction may misleadingly suggest volume responsiveness. We aimed to assess prediction of volume responsiveness with PPV in patients with increased pulmonary artery pressure. METHODS:Fifteen cardiac surgery patients with a ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc9060

    authors: Wyler von Ballmoos M,Takala J,Roeck M,Porta F,Tueller D,Ganter CC,Schröder R,Bracht H,Baenziger B,Jakob SM

    更新日期:2010-01-01 00:00:00

  • Long-term risk of sepsis among survivors of acute kidney injury.

    abstract::Many prior studies have shown that, in critically ill patients, acute kidney injury (AKI) commonly occurs in association with sepsis and its presence portends an increased likelihood of poor outcomes. In contrast, few studies have focused specifically on the influence of AKI on the long-term risk of developing sepsis....

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc13708

    authors: Clark E,Bagshaw SM

    更新日期:2014-01-24 00:00:00

  • Costs, outcome and cost-effectiveness of neurocritical care: a multi-center observational study.

    abstract:BACKGROUND:Neurocritical illness is a growing healthcare problem with profound socioeconomic effects. We assessed differences in healthcare costs and long-term outcome for different forms of neurocritical illnesses treated in the intensive care unit (ICU). METHODS:We used the prospective Finnish Intensive Care Consort...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s13054-018-2151-5

    authors: Raj R,Bendel S,Reinikainen M,Hoppu S,Laitio R,Ala-Kokko T,Curtze S,Skrifvars MB

    更新日期:2018-09-20 00:00:00

  • The circular RNA landscape in specific peripheral blood mononuclear cells of critically ill patients with sepsis.

    abstract:BACKGROUND:Dysregulation of the host immune response is a pathognomonic feature of sepsis. Abnormal physiological conditions are understood to shift efficient linear splicing of protein-coding RNA towards non-canonical splicing, characterized by the accumulation of non-coding circularized (circ)RNA. CircRNAs remain une...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-03146-4

    authors: Khan HN,Brands X,Aufiero S,Hoogendijk AJ,Klarenbeek AM,van Engelen TSR,Haak BW,van Vught LA,Horn J,Schultz MJ,Zwinderman AH,van der Poll T,Scicluna BP

    更新日期:2020-07-13 00:00:00

  • A systematic review of biomarkers multivariately associated with acute respiratory distress syndrome development and mortality.

    abstract:BACKGROUND:Heterogeneity of acute respiratory distress syndrome (ARDS) could be reduced by identification of biomarker-based phenotypes. The set of ARDS biomarkers to prospectively define these phenotypes remains to be established. OBJECTIVE:To provide an overview of the biomarkers that were multivariately associated ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-020-02913-7

    authors: van der Zee P,Rietdijk W,Somhorst P,Endeman H,Gommers D

    更新日期:2020-05-24 00:00:00

  • Intraoperative milrinone versus dobutamine in cardiac surgery patients: a retrospective cohort study on mortality.

    abstract:BACKGROUND:Several choices of inotropic therapy are available and used in relation to cardiac surgery. Comparisons are necessary to select optimal therapy. In Denmark, dobutamine and milrinone are the two inotropic agents most commonly used to treat post-bypass low cardiac output syndrome. This study compares all-cause...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-018-1969-1

    authors: Nielsen DV,Torp-Pedersen C,Skals RK,Gerds TA,Karaliunaite Z,Jakobsen CJ

    更新日期:2018-02-26 00:00:00

  • Early fibrinogen concentrate therapy for major haemorrhage in trauma (E-FIT 1): results from a UK multi-centre, randomised, double blind, placebo-controlled pilot trial.

    abstract:BACKGROUND:There is increasing interest in the timely administration of concentrated sources of fibrinogen to patients with major traumatic bleeding. Following evaluation of early cryoprecipitate in the CRYOSTAT 1 trial, we explored the use of fibrinogen concentrate, which may have advantages of more rapid administrati...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1186/s13054-018-2086-x

    authors: Curry N,Foley C,Wong H,Mora A,Curnow E,Zarankaite A,Hodge R,Hopkins V,Deary A,Ray J,Moss P,Reed MJ,Kellett S,Davenport R,Stanworth S

    更新日期:2018-06-18 00:00:00

  • Transcranial Doppler combined with quantitative EEG brain function monitoring and outcome prediction in patients with severe acute intracerebral hemorrhage.

    abstract:BACKGROUND:Neurological deterioration after intracerebral hemorrhage (ICH) is thought to be closely related to increased intracranial pressure (ICP), decreased cerebral blood flow (CBF), and brain metabolism. Transcranial Doppler (TCD) is increasingly used as an indirect measure of ICP, and quantitative EEG (QEEG) can ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-018-1951-y

    authors: Chen Y,Xu W,Wang L,Yin X,Cao J,Deng F,Xing Y,Feng J

    更新日期:2018-02-20 00:00:00

  • Monitoring and oversight in critical care research.

    abstract::Institutionally based research ethics review is a form of peer review that has - for better or worse - become the norm throughout the world. The vast majority of research ethics review takes the form of protocol review alone, conducted in advance of the research. Although oversight and monitoring in clinical research ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc2964

    authors: Lavery JV,Van Laethem ML,Slutsky AS

    更新日期:2004-12-01 00:00:00

  • Refeeding syndrome influences outcome of anorexia nervosa patients in intensive care unit: an observational study.

    abstract:INTRODUCTION:Data on the epidemiology and management of anorexia nervosa (AN) in the intensive care unit (ICU) are scarce. The aim of this study was to evaluate the prevalence and associated morbidity and mortality of AN in French ICUs. METHODS:We randomly selected 30 ICUs throughout France. Thereafter, we retrospecti...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1186/cc9274

    authors: Vignaud M,Constantin JM,Ruivard M,Villemeyre-Plane M,Futier E,Bazin JE,Annane D,AZUREA group (AnorexieRea Study Group).

    更新日期:2010-01-01 00:00:00

  • Vasopressin in vasodilatory shock: hemodynamic stabilization at the cost of the liver and the kidney?

    abstract::Infusing arginine vasopressin (AVP) in advanced vasodilatory shock is usually accompanied by a decrease in cardiac index and systemic oxygen transport. Whether or not such a vasoconstriction impedes regional blood flow and thus visceral organ function, even when low AVP is used, is still a matter of debate. Krejci and...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章,评审

    doi:10.1186/cc6171

    authors: Bracht H,Asfar P,Radermacher P,Calzia E

    更新日期:2007-01-01 00:00:00

  • Drotrecogin alfa (activated): does current evidence support treatment for any patients with severe sepsis?

    abstract::Two international multicentre randomised controlled trials of drotrecogin alfa (activated) (DrotAA), the Recombinant Human Activated Protein C Worldwide Evaluation of Severe Sepsis (PROWESS) and Administration of Drotrecogin Alfa (Activated) in Early Stage Severe Sepsis (ADDRESS) trials, have produced inconsistent res...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc4947

    authors: Friedrich JO,Adhikari NK,Meade MO

    更新日期:2006-01-01 00:00:00

  • Bench-to-bedside review: weaning failure--should we rest the respiratory muscles with controlled mechanical ventilation?

    abstract::The use of controlled mechanical ventilation (CMV) in patients who experience weaning failure after a spontaneous breathing trial or after extubation is a strategy based on the premise that respiratory muscle fatigue (requiring rest to recover) is the cause of weaning failure. Recent evidence, however, does not suppor...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc3917

    authors: Vassilakopoulos T,Zakynthinos S,Roussos C

    更新日期:2006-02-01 00:00:00

  • Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients.

    abstract:BACKGROUND:Middle East respiratory syndrome coronavirus infection is associated with high mortality rates but limited clinical data have been reported. We describe the clinical features and outcomes of patients admitted to an intensive care unit (ICU) with Middle East respiratory syndrome coronavirus (MERS-CoV) infecti...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1303-8

    authors: Almekhlafi GA,Albarrak MM,Mandourah Y,Hassan S,Alwan A,Abudayah A,Altayyar S,Mustafa M,Aldaghestani T,Alghamedi A,Talag A,Malik MK,Omrani AS,Sakr Y

    更新日期:2016-05-07 00:00:00

  • The dynamic pattern of end-tidal carbon dioxide during cardiopulmonary resuscitation: difference between asphyxial cardiac arrest and ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest.

    abstract:INTRODUCTION:Partial pressure of end-tidal carbon dioxide (PetCO2) during cardiopulmonary resuscitation (CPR) correlates with cardiac output and consequently has a prognostic value in CPR. In our previous study we confirmed that initial PetCO2 value was significantly higher in asphyxial arrest than in ventricular fibri...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc9417

    authors: Lah K,Križmarić M,Grmec S

    更新日期:2011-01-01 00:00:00

  • The race against the "septic shark".

    abstract::Great white sharks are responsible for about 10 cases of death annually worldwide, as compared with millions of deaths caused by sepsis. However, the basic principles of avoiding shark attacks and fighting sepsis seem to be similar: avoidance, attention, and speed, if necessary. The present review discusses the curren...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc14729

    authors: Westphal M,Kampmeier T

    更新日期:2015-01-01 00:00:00

  • In vivo validation of the adequacy calculator for continuous renal replacement therapies.

    abstract:INTRODUCTION:The study was conducted to validate in vivo the Adequacy Calculator, a Microsoft Excel-based program, designed to assess the prescription and delivery of renal replacement therapy in the critical care setting. METHODS:The design was a prospective cohort study, set in two intensive care units of teaching h...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc3517

    authors: Ricci Z,Salvatori G,Bonello M,Pisitkun T,Bolgan I,D'Amico G,Dan M,Piccinni P,Ronco C

    更新日期:2005-06-01 00:00:00

  • Seven unconfirmed ideas to improve future ICU practice.

    abstract::With imprecise definitions, inexact measurement tools, and flawed study execution, our clinical science often lags behind bedside experience and simply documents what appear to be the apparent faults or validity of ongoing practices. These impressions are later confirmed, modified, or overturned by the results of the ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-017-1904-x

    authors: Marini JJ,De Backer D,Ince C,Singer M,Van Haren F,Westphal M,Wischmeyer P

    更新日期:2017-12-28 00:00:00

  • Short-term outcomes of cadaveric lung transplantation in ventilator-dependent patients.

    abstract:INTRODUCTION:Survival after cadaveric lung transplantation (LTx) in respiratory failure recipients who were already dependent on ventilation support prior to transplantation is poor, with a relatively high rate of surgical mortality and morbidity. In this study, we sought to describe the short-term outcomes of bilatera...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7989

    authors: Hsu HH,Chen JS,Ko WJ,Huang SC,Kuo SW,Huang PM,Chi NH,Chang CC,Chen RJ,Lee YC

    更新日期:2009-01-01 00:00:00

  • Uncalibrated pulse power analysis fails to reliably measure cardiac output in patients undergoing coronary artery bypass surgery.

    abstract:INTRODUCTION:Uncalibrated arterial pulse power analysis has been recently introduced for continuous monitoring of cardiac index (CI). The aim of the present study was to compare the accuracy of arterial pulse power analysis with intermittent transpulmonary thermodilution (TPTD) before and after cardiopulmonary bypass (...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc10065

    authors: Broch O,Renner J,Höcker J,Gruenewald M,Meybohm P,Schöttler J,Steinfath M,Bein B

    更新日期:2011-01-01 00:00:00

  • Broadening our perspectives on ICU delirium risk factors.

    abstract::ICU delirium is associated with poor patient outcome. Risk factor stratification is essential to the understanding, prevention and treatment of this disorder. Alcohol consumption, smoking and prior cognitive impairment appear strongly correlated with delirium risk. Several potentially modifiable associations deserve p...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc7917

    authors: Skrobik Y

    更新日期:2009-01-01 00:00:00

  • Using an expiratory resistor, arterial pulse pressure variations predict fluid responsiveness during spontaneous breathing: an experimental porcine study.

    abstract:INTRODUCTION:Fluid responsiveness prediction is difficult in spontaneously breathing patients. Because the swings in intrathoracic pressure are minor during spontaneous breathing, dynamic parameters like pulse pressure variation (PPV) and systolic pressure variation (SPV) are usually small. We hypothesized that during ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7760

    authors: Dahl MK,Vistisen ST,Koefoed-Nielsen J,Larsson A

    更新日期:2009-01-01 00:00:00

  • Point accuracy and reliability of an interstitial continuous glucose-monitoring device in critically ill patients: a prospective study.

    abstract:INTRODUCTION:There is a need for continuous glucose monitoring in critically ill patients. The objective of this trial was to determine the point accuracy and reliability of a device designed for continuous monitoring of interstitial glucose levels in intensive care unit patients. METHODS:We evaluated point accuracy b...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-0757-4

    authors: van Hooijdonk RT,Leopold JH,Winters T,Binnekade JM,Juffermans NP,Horn J,Fischer JC,van Dongen-Lases EC,Schultz MJ

    更新日期:2015-02-05 00:00:00

  • Effects of a swallowing and oral care intervention for patients following endotracheal extubation: a pre- and post-intervention study.

    abstract:BACKGROUND:For patients who survive a critical illness and have their oral endotracheal tube removed, dysphagia is highly prevalent, and without intervention, it may persist far beyond hospital discharge. This pre- and post-intervention study with historical controls tested the effects of a swallowing and oral care (SO...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-019-2623-2

    authors: Wu CP,Xu YJ,Wang TG,Ku SC,Chan DC,Lee JJ,Wei YC,Hsiao TY,Chen CC

    更新日期:2019-11-09 00:00:00

  • Oxygen deficit and H2S in hemorrhagic shock in rats.

    abstract:INTRODUCTION:Hemorrhagic shock induced O2 deficit triggers inflammation and multiple organ failure (MOF). Endogenous H2S has been proposed to be involved in MOF since plasma H2S concentration appears to increase in various types of shocks and to predict mortality. We tested the hypothesis that H2S increases during hemo...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc11661

    authors: Van de Louw A,Haouzi P

    更新日期:2012-10-02 00:00:00

  • Mechanical ventilation with high tidal volume induces inflammation in patients without lung disease.

    abstract:INTRODUCTION:Mechanical ventilation (MV) with high tidal volumes may induce or aggravate lung injury in critical ill patients. We compared the effects of a protective versus a conventional ventilatory strategy, on systemic and lung production of tumor necrosis factor-alpha (TNF-alpha) and interleukin-8 (IL-8) in patien...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc8919

    authors: Pinheiro de Oliveira R,Hetzel MP,dos Anjos Silva M,Dallegrave D,Friedman G

    更新日期:2010-01-01 00:00:00