Systematic reviews and meta‐analyses: Sleep in the intensive care unit and near wind turbines

Abstract BackgroundInfection is a common problem and a major cause of morbidity and mortality for patients in intensive care units (ICUs). Oral care has been found to reduce the risk of nosocomial pneumonia according to published meta-analysis, and has been recommended to improve the oral environment for the patients in ICUs. However, relatively little information is available about the effects of oral care in patients without ventilatory support in ICUs. Therefore, this study was designed to evaluate the effectiveness of oral care in preventing pneumonia in non-ventilated ICUs patients.MethodsThe literature source will be gained from eight databases including four Chinese online databases and four English online databases from their inception to December 31, 2020. Records obtained will be managed and screened via Endnote X7，a widely used reference management software. The duplicate literature will be removed. All literature will be selected in accordance with pre-established inclusion criteria by two independent review authors to obtain quality trials. The quality of the included records will be evaluated according to “Risk of table”, recommended by Cochrane Handbook for Systematic Reviews of Interventions. All the data will be extracted by one author and checked by another. If there is any disagreement, a final agreement will be reached with a third reviewer via consulting. The data obtained will be managed via Microsoft Excel. If there is missing data, the original authors will be emailed to ask for it. If enough data was collected, the data synthesis will be performed using Review Manager (RevMan5.3). Otherwise, only the qualitative analysis will be carried out. The overall effect will be estimated on oral care for intensive care unit patients without mechanical ventilation to prevent nosocomial pneumonia using random effect model or fixed effect model base on the heterogeneity results. The sources of heterogeneity will be performed using Meta-regression and subgroup analysis if there is significant heterogeneity. The funnel plot will be used to assess the publish bias, if there are enough records included. The Cochrane Handbook for Systematic Reviews of Interventions will be followed throughout the system evaluation process.ConclusionThis study will provide evidence of oral care for intensive care unit patients without mechanical ventilation to prevent nosocomial pneumonia.PROSPERO Research registration identifying numberCRD42020146932

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The effect of prone positioning on pressure injury incidence in adult intensive care unit patients: A meta-review of systematic reviews

Australian Critical Care ◽

10.1016/j.aucc.2021.10.003 ◽

2021 ◽

Author(s):

Declan Patton ◽

Sharon Latimer ◽

Pinar Avsar ◽

Rachel M. Walker ◽

Zena Moore ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Systematic Reviews ◽

Injury Incidence ◽

Prone Positioning ◽

Adult Intensive Care Unit ◽

Meta Review ◽

Pressure Injury

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Awareness and bispectral index (BIS) monitoring in mechanically ventilated patients in the emergency department and intensive care unit: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2019-034673 ◽

2020 ◽

Vol 10 (3) ◽

pp. e034673 ◽

Cited By ~ 1

Author(s):

Ryan D Pappal ◽

Brian W Roberts ◽

Winston Winkler ◽

Lauren H Yaegar ◽

Robert J Stephens ◽

...

Keyword(s):

Systematic Review ◽

Intensive Care Unit ◽

Emergency Department ◽

Intensive Care ◽

Systematic Reviews ◽

Bispectral Index ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Bispectral Index Monitoring ◽

Ventilated Patients

IntroductionAccidental awareness with recall is one of the most feared complications for patients undergoing general anaesthesia and can lead to post-traumatic stress disorder in up to 70% of patients experiencing it. To reduce the incidence of awareness with recall, the bispectral index monitor is recommended for patients receiving total intravenous anaesthetics, especially those receiving neuromuscular blockers. While extensive investigation into awareness and bispectral index monitoring has occurred for operating room patients, this has not extended to other clinical arenas where sedated and mechanically ventilated patients are cared for, namely the intensive care unit and emergency department. The purpose of this systematic review is to assess the world’s literature to determine the incidence of awareness with paralysis in mechanically ventilated patients and the impact of bispectral index monitoring for reducing this complication.Methods and analysisRandomised trials and non-randomised studies are eligible for inclusion. With aid from a medical librarian, an electronic search will include Ovid Medline, Embase.com, Scopus, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials. To find data published in abstract form, literature from professional society conferences (2010–2019) will be manually searched. Two authors will independently review search results and consensus will be reached with assistance from a third author, as needed. Heterogeneity and publication bias will be assessed and reported. If possible and appropriate, a meta-analysis of the data will be conducted for quantitative data analysis.Ethics and disseminationThe proposed systematic review does not require ethical approval, as it is conducted at the study level and does not involve individual patient-level data. Results will be disseminated by data sharing via academically established means, presentation at local and national scientific meetings and publication as a peer-reviewed manuscript.PROSPERO registration numberThe protocol has been submitted to International Prospective Register of Systematic Reviews and is awaiting registration.

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Temporal trends of sex differences for COVID-19 infection, hospitalisation, severe disease, intensive care unit (ICU) admission and death: a meta-analysis of 229 studies covering over 10M patients

F1000Research ◽

10.12688/f1000research.74645.1 ◽

2022 ◽

Vol 11 ◽

pp. 5

Author(s):

Bart G. Pijls ◽

Shahab Jolani ◽

Anique Atherley ◽

Janna I.R. Dijkstra ◽

Gregor H.L. Franssen ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Disease Severity ◽

Meta Analysis ◽

Severe Disease ◽

Temporal Trends ◽

Icu Admission ◽

Risk Of Death ◽

Relative Risks ◽

Meta Analyses

Background: This review aims to investigate the association of sex with the risk of multiple COVID-19 health outcomes, ranging from infection to death. Methods: Pubmed and Embase were searched through September 2020. We considered studies reporting sex and coronavirus disease 2019 (COVID-19) outcomes. Qualitative and quantitative data were extracted using standardised electronic data extraction forms with the assessment of Newcastle Ottawa Scale for risk of bias. Pooled trends in infection, hospitalization, severity, intensive care unit (ICU) admission and death rate were calculated separately for men and women and subsequently random-effects meta-analyses on relative risks (RR) for sex was performed. Results: Of 10,160 titles, 229 studies comprising 10,417,452 patients were included in the analyses. Methodological quality of the included studies was high (6.9 out of 9). Men had a higher risk for infection with COVID-19 than women (RR = 1.14, 95%CI: 1.07 to 1.21). When infected, they also had a higher risk for hospitalization (RR = 1.33, 95%CI: 1.27 to 1.41), higher risk for severe COVID-19 (RR = 1.22, 95%CI: 1.17 to 1.27), higher need for Intensive Care (RR = 1.41, 95%CI: 1.28 to 1.55), and higher risk of death (RR = 1.35, 95%CI: 1.28 to 1.43). Within the period studied, the RR for infection and severity increased for men compared to women, while the RR for mortality decreased for men compared to women. Conclusions: Meta-analyses on 229 studies comprising over 10 million patients showed that men have a higher risk for COVID-19 infection, hospitalization, disease severity, ICU admission and death. The relative risks of infection, disease severity and death for men versus women showed temporal trends with lower relative risks for infection and severity of disease and higher relative risk for death at the beginning of the pandemic compared to the end of our inclusion period. PROSPERO registration: CRD42020180085 (20/04/2020)

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Reducing sound and light exposure to improve sleep on the adult intensive care unit: An inclusive narrative review

Journal of the Intensive Care Society ◽

10.1177/1751143717740803 ◽

2017 ◽

Vol 19 (2) ◽

pp. 138-146 ◽

Cited By ~ 11

Author(s):

Victoria Bion ◽

Alex SW Lowe ◽

Zudin Puthucheary ◽

Hugh Montgomery

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Intensive Care Units ◽

Positive Impact ◽

Light Exposure ◽

Environmental Interventions ◽

Adult Intensive Care Unit ◽

Patient Groups ◽

Environmental Measures ◽

Meta Analyses

Purpose Sleep disturbance is common in intensive care units. It is associated with detrimental psychological impacts and has potential to worsen outcome. Irregular exposure to sound and light may disrupt circadian rhythm and cause frequent arousals from sleep. We sought to review the efficacy of environmental interventions to reduce sound and light exposure with the aim of improving patient sleep on adult intensive care units. Methods We searched both PubMed (1966–30 May 2017) and Embase (1974–30 May 2017) for all relevant human (adult) studies and meta-analyses published in English using search terms ((intensive care OR critical care), AND (sleep OR sleep disorders), AND (light OR noise OR sound)). Bibliographies were explored. Articles were included if reporting change in patient sleep in response to an intervention to reduce disruptive intensive care unit sound /light exposure. Results Fifteen studies were identified. Nine assessed mechanical interventions, four of which used polysomnography to assess sleep. Five studies looked at environmental measures to facilitate sleep and a further two (one already included as assessing a mechanical intervention) studied the use of sound to promote sleep. Most studies found a positive impact of the intervention on sleep. However, few studies used objective sleep assessments, sample sizes were small, methodologies sometimes imperfect and analysis limited. Data are substantially derived from specialist (neurosurgical, post-operative, cardiothoracic and cardiological) centres. Patients were often at the ‘less sick’ end of the spectrum in a variety of settings (open ward beds or side rooms). Conclusions Simple measures to reduce intensive care unit patient sound/light exposure appear effective. However, larger and more inclusive high-quality studies are required in order to identify the measures most effective in different patient groups and any impacts on outcome.

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Effect of daily sedation interruption and the patient’s outcome who are under mechanical ventilation: A mini systematic review

International Journal of Medical Science and Diagnosis Research ◽

10.32553/ijmsdr.v4i12.714 ◽

2020 ◽

Vol 4 (12) ◽

Author(s):

Konstantina Satolia ◽

Dimitrios Alefragkis

Keyword(s):

Systematic Review ◽

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Length Of Stay ◽

Total Duration ◽

Cochrane Library ◽

Continuous Administration ◽

Meta Analyses ◽

Daily Sedation Interruption

Continuous administration of sedatives to the intensive care unit may increase the duration of mechanical ventilation, extend the patient's stay in the intensive care unit, and, subsequently, to the hospital. The objective was to improve the outcome of intubated patients in terms of the total duration of mechanical ventilation, the stay of these patients in the intensive care unit (ICU), and their mortality. This systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was conducted in October 2020. Articles were searched in the PubMed and Cochrane Library online databases. Data were extracted from all included research studies and analyzed thematically. The search duration was between 2008 and 2018. The studies do not document statistically significant differences with the parameters under study (total duration of mechanical ventilation, the total length of stay in the intensive care unit (ICU), and mortality), for a better outcome of intubated patients. The application of the daily sedation interruption (DSI) did not appear to affect the duration of Mechanical Ventilation, the length of stay in the ICU, and mortality in intubated patients. Keywords: Daily sedation interruption, intubated patients

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Oral care for intensive care unit patients without mechanical ventilation: protocol for a systematic review and meta-analysis

Systematic Reviews ◽

10.1186/s13643-021-01878-0 ◽

2022 ◽

Vol 11 (1) ◽

Author(s):

Xiaoxia Tang ◽

Yunxia Shen ◽

Xuejiao Pan ◽

Jianglong Liao ◽

Yanfei Xu ◽

...

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Nosocomial Pneumonia ◽

Systematic Reviews ◽

Meta Analysis ◽

Oral Care ◽

Publication Date ◽

Significant Heterogeneity ◽

Effect Model

Abstract Background Infection is a common problem and a major cause of morbidity and mortality for patients in intensive care units (ICUs). According to published meta-analyses, oral care has been found to reduce the risk of nosocomial pneumonia, and has been recommended to improve the oral environment for patients in ICUs. However, relatively little information is available about the effects of oral care in patients without ventilatory support in ICUs. Therefore, this review proposes to evaluate the effectiveness of oral care in preventing pneumonia in non-ventilated ICU patients. Methods Eight databases will be searched for relevant literature, including four Chinese and four English online databases, from their inception to the protocol publication date. Records obtained will be managed and screened via Endnote X7. All literature will be selected following pre-established inclusion criteria by two independent review authors to obtain quality trials. The quality of the included records will be evaluated according to the “risk of bias table”, recommended by the Cochrane Handbook for Systematic Reviews of Interventions. All the data will be extracted by one author and checked by another. If there is any disagreement, a final agreement will be reached with a third reviewer via consultation. If there are missing data, the original authors will be emailed to ask for it. If enough data were collected, the data synthesis will be performed using Review Manager (RevMan5.3). Both a random effect model and a fixed effect model will be undertaken. A Bayesian meta-analysis will also be performed to estimate the magnitude of the heterogeneity variance and comparing it with the distribution using the WinBUGS software. Otherwise, the results will be reported narratively. The sources of heterogeneity will be determined using meta-regression and subgroup analysis if there is significant heterogeneity. A funnel plot will be used to assess publication bias if there are enough records included. The Cochrane Handbook for Systematic Reviews of Interventions will be followed throughout the system evaluation process. Conclusion This review will provide evidence of oral care for intensive care unit patients without mechanical ventilation to prevent nosocomial pneumonia. Trial registration PROSPERO Research registration identifying number: CRD42020146932

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The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00097 ◽

2019 ◽

Vol 4 (6) ◽

pp. 1507-1515

Author(s):

Lauren L. Madhoun ◽

Robert Dempster

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Hospital Discharge ◽

Neonatal Intensive Care ◽

Oral Feeding ◽

Medical Attention ◽

Primary Role ◽

Speech Language Pathologists ◽

The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

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