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Báo cáo y học: "Effect of histamine-2-receptor antagonists versus sucralfate on stress ulcer prophylaxis in mechanically ventilated patients: a meta-analysis of 10 randomized controlled trials"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Effect of histamine-2-receptor antagonists versus sucralfate on stress ulcer prophylaxis in mechanically ventilated patients: a meta-analysis of 10 randomized controlled trials. | Huang et al. Critical Care 2010 14 R194 http ccforum.eom content 14 5 R194 c CRITICAL CARE RESEARCH Open Access Effect of histamine-2-receptor antagonists versus sucralfate on stress ulcer prophylaxis in mechanically ventilated patients a meta-analysis of 10 randomized controlled trials Jiahao Huang Yunfei Cao Cun Liao Liucheng Wu Feng Gao Abstract Introduction We conducted a meta-analysis in order to investigate the effect of histamine-2-receptor antagonists H2RA versus sucralfate on stress ulcer prophylaxis in mechanically ventilated patients in the intensive care unit ICU . Methods A systematic literature search of Medline EMBASE Cochrane Central Register of Controlled Trials 1966 to January 2010 was conducted using specific search terms. A review of Web of Science and a manual review of references were also performed. Eligible studies were randomized control trials RCTs that compared H2RA and sucralfate for the prevention of stress ulcer in mechanically ventilated patients. Main outcome measures were rates of overt bleeding clinically important gastrointestinal GI bleeding ventilator-associated pneumonia gastric colonization and ICU mortality. Results Ten RCTs with 2 092 participants on mechanical ventilation were identified. Meta-analysis showed there was a trend toward decreased overt bleeding when H2RA was compared with sucralfate OR 0.87 95 CI 0.49 to 1.53 . A total of 12 clinically important GI bleeding events occurred among 667 patients 1.8 in the H2RA group compared with 26 events among 673 patients 3.9 in the sucralfate groups. Prophylaxis with sucralfate decreased the incidence of gastric colonization OR 2.03 95 CI 1.29 to 3.19 and ventilator-associated pneumonia OR 1.32 95 CI 1.07 to 1.64 . Subgroup analysis showed H2RA was not superior to sucralfate in reducing early-onset pneumonia OR 0.62 95 CI 0.36 to 1.07 but had a higher late-onset pneumonia rate OR 4.36 95 CI 2.09 to 9.09 relative to sucralfate. No statistically significant reduction was .