tailieunhanh - Báo cáo y học: "Utility and safety of draining pleural effusions in mechanically ventilated patients: a systematic review and meta-analysis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Utility and safety of draining pleural effusions in mechanically ventilated patients: a systematic review and meta-analysis. | Goligher et al. Critical Care 2011 15 R46 http content 15 1 R46 KS CRITICAL CARE RESEARCH Open Access Utility and safety of draining pleural effusions in mechanically ventilated patients a systematic review and meta-analysis 2 3 3 3 14 Ewan C Goligher 1 Jerome A Leis Robert A Fowler Ruxandra Pinto Neill KJ Adhikari Niall D Ferguson 1 Abstract Introduction Pleural effusions are frequently drained in mechanically ventilated patients but the benefits and risks of this procedure are not well established. Methods We performed a literature search of multiple databases MEDLINE EMBASE HEALTHSTAR CINAHL up to April 2010 to identify studies reporting clinical or physiological outcomes of mechanically ventilated critically ill patients who underwent drainage of pleural effusions. Studies were adjudicated for inclusion independently and in duplicate. Data on duration of ventilation and other clinical outcomes oxygenation and lung mechanics and adverse events were abstracted in duplicate independently. Results Nineteen observational studies N 1 124 met selection criteria. The mean PaO2 FiO2 ratio improved by 18 95 confidence interval CI 5 to 33 2 five studies including 118 patients after effusion drainage. Reported complication rates were low for pneumothorax 20 events in 14 studies including 965 patients pooled mean 95 CI to 2 and hemothorax 4 events in 10 studies including 721 patients pooled mean 95 CI to 2 0 . The use of ultrasound guidance either real-time or for site marking was not associated with a statistically significant reduction in the risk of pneumothorax OR 95 CI to . Studies did not report duration of ventilation length of stay in the intensive care unit or hospital or mortality. Conclusions Drainage of pleural effusions in mechanically ventilated patients appears to improve oxygenation and is safe. We found no data to either support or refute claims of beneficial effects on clinically important .