scholarly journals Prophylactic administration of parenteral steroids for preventing airway complications after extubation in adults: meta-analysis of randomised placebo controlled trials

BMJ ◽  
2008 ◽  
Vol 337 (oct20 1) ◽  
pp. a1841-a1841 ◽  
Author(s):  
T. Fan ◽  
G. Wang ◽  
B. Mao ◽  
Z. Xiong ◽  
Y. Zhang ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Controlled Trials ◽  
Airway Complications ◽  
Prophylactic Administration

P271 Prophylactic administration of allopurinol with standard IV hydration in preventing contrast-induced nephropathy in patients undergoing cardiac catheterization: a meta-analysis and systematic review

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
R Larrazabal ◽  
B B P Perez ◽  
H C C Chiu ◽  
R J T Tan
Keyword(s):  
Meta Analysis ◽  
Kidney Injury ◽  
Fixed Effect Model ◽  
Inflammatory Factors ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Contrast Induced Nephropathy ◽  
Prophylactic Administration ◽  
Coronary Interventions ◽  
Study Results

Abstract Funding Acknowledgements None BACKGROUND Current advancements has made contrast-guided coronary interventions widely available, however these procedures entail the risk of  developing Contrast-induced nephropathy which is associated with increased morbidity and mortality of patients. One of the mechanisms that has been investigated in the development of CIN is the presence of hyperuricemia. Elevated uric acid levels may injure the microscopic tubules causing kidney injury and may induce the production of inflammatory factors furthering damage. Thus, it has been postulated that using urate lowering agents may be beneficial in preventing CIN. OBJECTIVE To determine the efficacy of giving oral prophylactic allopurinol along with standard IV hydration in reducing the incidence of contrast-induced nephropathy. METHODS We conducted a systematic literature search using PUBMED, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Kidney and Transplant register of Studies, Google Scholar, and Research Gate. Studies fulfilling the inclusion and exclusion criteria were quality assessed based on the criteria provided in the Cochrane Handbook for Systematic Reviews of Interventions. The incidences ofContrast-Induced Nephropathy were combined and analyzed using a fixed-effect model in Review Manager (Rev Man) Version 5.3 with 95% confidence interval. RESULTS Five studies were included with a total of 753 patients. Results showed that there is a 63% decrease in CIN [RR = 0.37 (0.25 to 0.54, 95% CI, Z = 5.10, p < 0.00001)] after prophylactic administration of allopurinol with standard IV hydration as compared to those who received hydration alone. When adjusted for heterogeneity, there remains a 35% decrease in the incidence of CIN [RR = 0.65 (0.43 to 0.99, 95% CI, Z = 2.02, p = 0.04) in patients given prophylactic allopurinol. CONCLUSION Oral prophylactic allopurinol administration may be protective in the development of CIN in patients undergoing coronary interventions. However larger, multi-centered randomized-controlled trials are needed to validate this claim. Abstract P271 Figure. Forrest Plot of Study Results

Interventions for suicide and self-injury: A meta-analysis of randomized controlled trials across nearly 50 years of research.

2020 ◽  
Vol 146 (12) ◽  
pp. 1117-1145
Author(s):  
Kathryn R. Fox ◽  
Xieyining Huang ◽  
Eleonora M. Guzmán ◽  
Kensie M. Funsch ◽  
Christine B. Cha ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Self Injury

The Effect of Desmopressin on Reducing Blood Loss in Cardiac Surgery – A Meta-Analysis of Double-Blind, Placebo-Controlled Trials

1995 ◽  
Vol 74 (04) ◽  
pp. 1064-1070 ◽  
Author(s):  
Marco Cattaneo ◽  
Alan S Harris ◽  
Ulf Strömberg ◽  
Pier Mannuccio Mannucci
Keyword(s):  
Cardiac Surgery ◽  
Blood Loss ◽  
Meta Analysis ◽  
Postoperative Blood Loss ◽  
Controlled Trials ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Transfusion Requirements ◽  
The Mean ◽  
Excessive Blood Loss

SummaryThe effect of desmopressin (DDAVP) on reducing postoperative blood loss after cardiac surgery has been studied in several randomized clinical trials, with conflicting outcomes. Since most trials had insufficient statistical power to detect true differences in blood loss, we performed a meta-analysis of data from relevant studies. Seventeen randomized, double-blind, placebo-controlled trials were analyzed, which included 1171 patients undergoing cardiac surgery for various indications; 579 of them were treated with desmopressin and 592 with placebo. Efficacy parameters were blood loss volumes and transfusion requirements. Desmopressin significantly reduced postoperative blood loss by 9%, but had no statistically significant effect on transfusion requirements. A subanalysis revealed that desmopressin had no protective effects in trials in which the mean blood loss in placebo-treated patients fell in the lower and middle thirds of distribution of blood losses (687-1108 ml/24 h). In contrast, in trials in which the mean blood loss in placebo-treated patients fell in the upper third of distribution (>1109 ml/24 h), desmopressin significantly decreased postoperative blood loss by 34%. Insufficient data were available to perform a sub-analysis on transfusion requirements. Therefore, desmopressin significantly reduces blood loss only in cardiac operations which induce excessive blood loss. Further studies are called to validate the results of this meta-analysis and to identify predictors of excessive blood loss after cardiac surgery.

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