scholarly journals Comparison of complications attributable to enteral and parenteral nutrition in predicted severe acute pancreatitis: a systematic review and meta-analysis

2010 ◽  
Vol 103 (9) ◽  
pp. 1287-1295 ◽  
Author(s):  
Maxim S. Petrov ◽  
Kevin Whelan
Keyword(s):  
Acute Pancreatitis ◽  
Parenteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Meta Analysis ◽  
Tube Feeding ◽  
Infectious Complications ◽  
Cochrane Library ◽  
Randomised Controlled ◽  
The Cochrane Library ◽  
Complications And Mortality

Enteral nutrition (EN) reduces infectious complications and mortality compared with parenteral nutrition (PN) in patients with predicted severe acute pancreatitis. However, to date the complications attributable to the administration of EN and PN in this patient group have not been comprehensively studied. The aim of the study was to systematically review the complications related to the use of nutrition in patients with predicted severe acute pancreatitis receiving EN v. PN. The Cochrane Library, MEDLINE and Scopus were searched. Randomised controlled trials (RCT) of EN v. PN in predicted severe acute pancreatitis were selected. Pooled estimates of complications were expressed as OR with corresponding 95 % CI. Data from five RCT were meta-analysed. Diarrhoea occurred in six of ninety-two (7 %) patients receiving PN and twenty-four of eighty-two (29 %) patients receiving EN (OR 0·20; 95 % CI 0·09, 0·43; P < 0·001). Hyperglycaemia developed in twenty-one of ninety-two (23 %) patients receiving PN and nine of eighty-two (11 %) receiving EN (OR 2·59; 95 % CI 1·13, 5·94; P = 0·03). Given a significant reduction in infectious complications and mortality associated with the use of EN over PN that has been consistently demonstrated in previous studies, the former should be the treatment of choice in acute pancreatitis. Further clinical studies should investigate the strategies to mitigate the complications of enteral tube feeding in patients with acute pancreatitis.

scholarly journals Assessment of Prophylactic Carbapenem Antibiotics Administration for Severe Acute Pancreatitis: An Updated Systematic Review and Meta-Analysis

Digestion ◽  
2022 ◽  
pp. 1-9
Author(s):  
Daxin Guo ◽  
Wei Dai ◽  
Jingyi Shen ◽  
Mengting Zhang ◽  
Yetan Shi ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Pseudocyst ◽  
Meta Analysis ◽  
Fluid Collection ◽  
Cochrane Library ◽  
Intensive Care Unit Treatment ◽  
Significant Difference ◽  
And Control

<b><i>Background:</i></b> The effectiveness of prophylactic antibiotics in severe acute pancreatitis (SAP) remains a debatable issue. This meta-analysis aimed to determine the efficacy of prophylactic carbapenem antibiotics in SAP. <b><i>Methods:</i></b> This meta-analysis of prophylactic carbapenem antibiotics for SAP was conducted in PubMed, EMBASE, Web of Science, MEDLINE, and Cochrane Library up to February 2021. The related bibliographies were manually searched. The primary outcomes involved infected pancreatic or peripancreatic necrosis, mortality, complications, infections, and organ failure. <b><i>Results:</i></b> Seven articles comprised 5 randomized controlled trials and 2 retrospective observational studies, including 3,864 SAP participants. Prophylactic carbapenem antibiotics in SAP were associated with a statistically significant reduction in the incidence of infections (odds ratio [OR]: 0.27; <i>p</i> = 0.03) and complications (OR: 0.48; <i>p</i> = 0.009). Nevertheless, no statistically significant difference was demonstrated in the incidence of infected pancreatic or peripancreatic necrosis (OR: 0.74; <i>p</i> = 0.24), mortality (OR: 0.69; <i>p</i> = 0.17), extrapancreatic infection (OR: 0.64, <i>p</i> = 0.54), pulmonary infection (OR: 1.23; <i>p</i> = 0.69), blood infection (OR: 0.60; <i>p</i> = 0.35), urinary tract infection (OR: 0.97; <i>p</i> = 0.97), pancreatic pseudocyst (OR: 0.59; <i>p</i> = 0.28), fluid collection (OR: 0.91; <i>p</i> = 0.76), organ failure (OR: 0.63; <i>p</i> = 0.19), acute respiratory distress syndrome (OR: 0.80; <i>p</i> = 0.61), surgical intervention (OR: 0.97; <i>p</i> = 0.93), dialysis (OR: 2.34; <i>p</i> = 0.57), use of respirator or ventilator (OR: 1.90; <i>p</i> = 0.40), intensive care unit treatment (OR: 2.97; <i>p</i> = 0.18), and additional antibiotics (OR: 0.59; <i>p</i> = 0.28) between the experimental and control groups. <b><i>Conclusions:</i></b> It is not recommended to administer routine prophylactic carbapenem antibiotics in SAP.

scholarly journals A systematic review on the timing of artificial nutrition in acute pancreatitis

2008 ◽  
Vol 101 (6) ◽  
pp. 787-793 ◽  
Author(s):  
Maxim S. Petrov ◽  
Romana D. Pylypchuk ◽  
Antonina F. Uchugina
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Infectious Complications ◽  
Multiple Organ ◽  
Artificial Nutrition ◽  
Controlled Trials ◽  
Randomised Controlled

Artificial nutrition is an inherent part of management in acute pancreatitis. However, there is no consensus regarding the optimal time of the commencement of feeding in these patients. Our aim was to compare the effect of enteral v. parenteral nutrition with regard to the time points when they were administered in the randomised controlled trials. The search was undertaken in the Cochrane Central Register of Controlled Trials, MEDLINE and Science Citation Index as well as in the proceedings of major gastroenterology meetings. The summary estimate of the effect associated with artificial nutrition was calculated using a random-effects model and presented as a risk ratio (RR) and 95 % CI. A total of eleven randomised controlled trials were included. When started within 48 h of admission, enteral nutrition, in comparison with parenteral nutrition, resulted in a statistically significant reduction in the risks of multiple organ failure (RR 0·44; 95 % CI 0·23, 0·84), pancreatic infectious complications (RR 0·46; 95 % CI 0·27, 0·77) and mortality (RR 0·46; 95 % CI 0·20, 0·99). After 48 h of admission, enteral nutrition, in comparison with parenteral nutrition, did not result in a statistically significant reduction in the risks of multiple organ failure (RR 0·73; 95 % CI 0·33, 1·63), pancreatic infectious complications (RR 0·31; 95 % CI 0·07, 1·34) and mortality (RR 0·67; 95 % CI 0·22, 2·10). Enteral nutrition is more effective than parenteral nutrition in reducing the risk of multiple organ failure, pancreatic infectious complications and mortality in patients with acute pancreatitis. The magnitude of these benefits may depend on the timing of the commencement of nutrition.

scholarly journals Face mask use in the Community for Reducing the Spread of COVID-19: a systematic review

2020 ◽  
Author(s):  
Daniela Coclite ◽  
Antonello Napoletano ◽  
Silvia Gianola ◽  
Andrea Del Monaco ◽  
Daniela D'Angelo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Community Setting ◽  
Face Mask ◽  
Cochrane Library ◽  
Case Scenario ◽  
Materials Used ◽  
Randomised Controlled ◽  
The Cochrane Library

Background: Evidence is needed on the effectiveness of wearing face masks in the community to prevent SARS-CoV-2 transmission. Methods: Systematic review and meta-analysis to investigate the efficacy and effectiveness of face mask use in a community setting and to predict the effectiveness of wearing a mask. We searched MEDLINE, EMBASE, SCISEARCH, The Cochrane Library and pre-prints from inception to 22 April 2020 without restriction by language. We rated the certainty of evidence according to Cochrane and GRADE approach. Findings: Our search identified 35 studies, including 3 randomised controlled trials (RCTs) (4017 patients), 10 comparative studies (18984 patients), 13 predictive models, 9 laboratory experimental studies. For reducing infection rates, the estimates of cluster-RCTs were in favour of wearing face masks versus no mask, but not at statistically significant levels (adjusted OR 0.90, 95%CI 0.78-1.05). Similar findings were reported in observational studies. Mathematical models indicated an important decrease in mortality when the population mask coverage is near-universal, regardless of mask efficacy. In the best-case scenario, when the mask efficacy is at 95%, the R0 can fall to 0.99 from an initial value of 16.90. Levels of mask filtration efficiency were heterogeneous, depending on the materials used (surgical mask: 45-97%). One laboratory study suggested a viral load reduction of 0.25 (95%CI 0.09-0.67) in favour of mask versus no mask. Interpretation: The findings of this systematic review and meta-analysis support the use of face masks in a community setting. Robust randomised trials on face mask effectiveness are needed to inform evidence-based policies.

scholarly journals Safety and efficacy of total parenteral nutrition versus total enteral nutrition for patients with severe acute pancreatitis: a meta-analysis

2018 ◽  
Vol 46 (9) ◽  
pp. 3948-3958 ◽  
Author(s):  
Wen Li ◽  
Jixi Liu ◽  
Shuqiao Zhao ◽  
Jingtao Li
Keyword(s):  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Safety And Efficacy ◽  
Pubmed Database ◽  
Total Enteral Nutrition

Objective This study was performed to systematically compare the safety and efficacy of total enteral nutrition (TEN) and total parenteral nutrition (TPN) for patients with severe acute pancreatitis (SAP). Methods The PubMed database was searched up to January 2017, and nine studies were retrieved. These studies were selected according to specific eligibility criteria. The methodological quality of each trial was assessed, and the study design, interventions, participant characteristics, and final results were then analyzed by Review Manager 5.3 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Results Nine relevant randomized controlled trials involving 500 patients (244 patients in the TEN group and 256 patients in the TPN group) were included in the meta-analysis. Pooled analysis showed a significantly lower mortality rate in the TEN than TPN group [odds ratio (OR), 0.31; 95% confidence interval (CI), 0.18–0.54]. The duration of hospitalization was significantly shorter in the TEN than TPN group (mean difference, −0.59; 95% CI, −2.56–1.38). Compared with TPN, TEN had a lower risk of pancreatic infection and related complications (OR, 0.41; 95% CI, 0.22–0.77), organ failure (OR, 0.17; 95% CI, 0.06–0.52), and surgical intervention (OR, 0.17; 95% CI, 0.05–0.62). Conclusions This meta-analysis indicates that TEN is safer and more effective than TPN for patients with SAP. When both TEN and TPN have a role in the management of SAP, TEN is the preferred option.

956 Enteral Nutrition Is Superior to Total Parenteral Nutrition in Severe Acute Pancreatitis: A Systematic Review and Meta-Analysis

2008 ◽  
Vol 134 (4) ◽  
pp. A-141 ◽  
Author(s):  
Nadim S. Jafri ◽  
Suhal S. Mahid ◽  
Swapna K. Gopathi ◽  
Carlton A. Hornung ◽  
Susan Galandiuk ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Pancreatitis ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Meta Analysis

scholarly journals Risk of Lower Eyelids Malposition in Subciliary Compared to Transconjunctival Approach in Maxillofacial Fractures Management: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 7 (17) ◽  
pp. 2953-2957
Author(s):  
I Gusti Putu Hendra Sanjaya ◽  
Agus Roy Rusly Hariantana Hamid ◽  
I Made Suka Adnyana ◽  
I Gusti Ayu Putri Purwanthi ◽  
Paulina Magdalena ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Meta Analysis ◽  
Open Access Journal ◽  
Cochrane Library ◽  
Transconjunctival Approach ◽  
Maxillofacial Fractures ◽  
Subciliary Approach ◽  
Randomised Controlled ◽  
The Cochrane Library

BACKGROUND: Both subciliary and transconjunctival approaches have been used for decades to visualise the site of the maxillofacial fracture. The most common complication following those procedures is lower eyelids malposition. AIM: This meta-analysis will analyse which approach (subciliary and transconjunctival approaches) is more favourable to decrease lower eyelids malposition incidence. METHOD: This meta-analysis was conducted based on PRISMA guidelines. The electronic search was conducted using keywords (“Lower Eyelids Malposition” OR “Complications” OR “Ectropion” OR “Entropion”) AND (Transconjunctival) AND (Subciliary) AND (Maxillofacial Fractures) in PubMed, The Cochrane Library, and Directory of Open Access Journal (DOAJ). This review included full-text studies (observational and randomised controlled trials) in English comparing subciliary and transconjunctival approach in patients with maxillofacial fractures in the last 10 years. The data collected were the type of fractures and approaches, ectropion and entropion incidence as well as follow-up duration. The risk of bias was assessed using Joanna Briggs Institute critical appraisal checklist. Statistical analysis was done using Review Manager 5.3 (Cochrane, Denmark). RESULT: This study included 3 cohort studies and 2 Randomized Controlled Trial (RCT) studies from 2012 to 2017 with a total of 574 samples. Subciliary approach had a significant higher ectropion incidence when compared to transconjunctival approach (RR = 4.64, 95% CI: 1.68-12.81, p = 0.003). There was also a significant reduction of entropion incidence in patients with subciliary approach compared to transconjunctival approach (RR = 0.16, 95% CI: 0.04 – 0.69, p = 0.01). CONCLUSION: There was no superiority between one procedure toward another since each procedure related to different lower eyelids malpositions.

scholarly journals Dezocine prevents sufentanil-induced cough during general anesthesia induction: a meta-analysis of randomised controlled trials

2019 ◽  
Author(s):  
Zhencheng Xiong ◽  
Ping Yi ◽  
Jipeng Song ◽  
Mingsheng Tan
Keyword(s):  
General Anesthesia ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Vital Signs ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Anesthesia Induction ◽  
China National Knowledge Infrastructure ◽  
Randomised Controlled ◽  
The Cochrane Library

Abstract Background Sufentanil is one of the opioids currently used to induce general anesthesia, and cough is one of the most common complications. Many drugs have been used to prevent sufentanil-induced cough (SIC), and dezocine is one of them. The purpose of our meta-analysis is to evaluate the efficacy of dezocine on SIC.Methods We searched multiple databases including PubMed, Embase, ScienceDirect, the Cochrane Library, and China National Knowledge Infrastructure databases (CNKI) to identify studies that met the inclusion criteria. This meta-analysis focused on the incidence and severity of SIC after dezocine intervention, as well as adverse effects.Results Five randomised controlled trials (RCTs) were identified, including 890 patients. Each study was a comparison of dezocine with an equal volume of 0.9% saline. When the injection dose of dezocine was 0.1 mg/kg, the incidence (pooled risk ratio [RR]=0.03, [95% CI: 0.02 to 0.07], P<0.00001, I2=0%) and severity (mild: RR=0.07, [95% CI: 0.03 to 0.18], P<0.00001, I2=0%; moderate: RR=0.05, [95% CI: 0.02 to 0.16], P<0.00001, I2=0%; severe: RR=0.04, [95% CI: 0.01 to 0.16], P<0.00001, I2=0%) of SIC were significantly decreased. There were no statistically significant differences in vital signs between the two groups based on the results of the pooled analysis.Conclusion This meta-analysis showed that dezocine significantly reduced the incidence and severity of SIC in the induction of general anesthesia, but had no significant effect on vital signs. More high-quality RCTs are needed to complement existing conclusions.

KOLABORASI PUSTAKAWAN DALAM PENGAMBILAN KEPUTUSAN KLINIS BERBASIS BUKTI TERKINI (EVIDENCE BASED MEDICINE ): STUDI KASUS DI FAKULTAS KEDOKTERAN, KESEHATAN MASYARAKAT DAN KEPERAWATAN UNIVERSITAS GADJAH MADA

2021 ◽  
Vol 23 (1) ◽  
pp. 67-75
Author(s):  
Sukirno Sukirno
Keyword(s):  
Systematic Review ◽  
Evidence Based Medicine ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Evidence Based ◽  
Randomised Controlled ◽  
The Cochrane Library ◽  
Clinical Queries ◽  
Based Medicine

Evidence Based Medicine (EBM) merupakan pemanfaatan bukti ilmiah berdasarkan penelitian klinis mutakhir yang sahih dalam tatalaksana proses penyembuhan penyakit. Salah satu syarat utama untuk memfasilitasi pengambilan keputusan klinik yang evidence-based, adalah dengan menyediakan bukti-bukti ilmiah yang relevan. Tipe kajian  diutamakan yang berupa hasil review sistematik, meta-analisis, dan randomised controlled trial (RCT). Salah satu dari lima langkah dalam evidence based medicine yaitu yaitu menelusur  bukti  dari sumber database hasil penelitian yang memuat bukti-bukti ilmiah. PubMed Clinical Queries dan The Cochrane Library merupakan database berisi hasil riset sekunder (systematic-review/meta-analysis) yang mensintesis hasil riset primer. Kolaborasi pustakawan dalam pengambilan keputusan klinis yaitu dengan  memberikan pelatihan  atau menelusur artikel hasil penelitian yang akan digunakan dalam pengambilan klinis dari database yang memuat bukti ilmiah.

Sign in / Sign up

Export Citation Format

Share Document