The effect of early mobilization for critical ill patients requiring mechanical ventilation: a systematic review and meta-analysis

2018 ◽  
Vol 2 ◽  
pp. 9-9 ◽  
Author(s):  
Gensheng Zhang ◽  
Kai Zhang ◽  
Wei Cui ◽  
Yucai Hong ◽  
Zhongheng Zhang
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Meta Analysis ◽  
Early Mobilization ◽  
Critical Ill Patients ◽  
Critical Ill

scholarly journals Glutamine on critical-ill patients: a systematic review and meta-analysis

2020 ◽  
Vol 9 (6) ◽  
pp. 68-68
Author(s):  
Yueming Sun ◽  
Sainan Zhu ◽  
Shuangling Li ◽  
Hong Liu
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Critical Ill Patients ◽  
Critical Ill

scholarly journals P059: Early mobilization of trauma patients admitted to intensive care units: a systematic review and meta-analysis

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S84
Author(s):  
S. Higgins ◽  
M. Erdogan ◽  
J. Coles ◽  
R. Green
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Meta Analysis ◽  
Grey Literature ◽  
Early Mobilization ◽  
The United States ◽  
Cochrane Library ◽  
Trauma Patients ◽  
Icu Patients

Introduction: Previous systematic reviews suggest early mobilization in the intensive care unit (ICU) population is feasible, safe, and may improve outcomes. Only one review investigated mobilization specifically in trauma ICU patients and failed to identify any relevant articles. The objective of the present systematic review was to conduct an up-to-date search of the literature to assess the effect of early mobilization in adult trauma ICU patients on mortality, length of stay (LOS) and duration of mechanical ventilation. Methods: We performed a systematic search of four electronic databases (Ovid MEDLINE, Embase, CINAHL, Cochrane Library) and the grey literature. To be included, studies must have compared early mobilization to delayed or no mobilization among trauma patients admitted to the ICU. Meta-analysis was performed to determine the effect of early mobilization on mortality, hospital LOS, ICU LOS, and duration of mechanical ventilation. Results: The search yielded 2,975 records from the 4 databases and 7 records from grey literature and bibliographic searches; of these, 9 articles met all eligibility criteria and were included in the analysis. There were 7 studies performed in the United States, 1 study from China and 1 study from Norway. Study populations included neurotrauma (3 studies), blunt abdominal trauma (2 studies), mixed injury types (2 studies) and burns (1 study). Cohorts ranged in size from 15 to 1,132 patients (median, 63) and varied in inclusion criteria. Most studies used some form of stepwise progressive mobility protocol. Two studies used simple ambulation as the mobilization measure, and 1 study employed upright sitting as their only intervention. Time to commencement of the intervention was variable across studies, and only 2 studies specified the timing of mobilization initiation. We did not detect a difference in mortality with early mobilization, although the pooled risk ratio (RR) was reduced (RR 0.90, 95% CI 0.74 to 1.09). Hospital LOS and ICU LOS were decreased with early mobilization, though this difference did not reach significance. Duration of mechanical ventilation was significantly shorter in the early mobilization group (mean difference −1.18. 95% CI −2.17 to −0.19). Conclusion: Our review identified few studies that examined mobilization of critically ill trauma patients in the ICU. On meta-analysis, early mobilization was found to reduce duration of mechanical ventilation, but the effects on mortality and LOS were not significant.

Effects of Inspiratory Muscle Training and Early Mobilization on Weaning of Mechanical Ventilation: A Systematic Review and Network Meta-analysis

2020 ◽  
Vol 101 (11) ◽  
pp. 2002-2014
Author(s):  
Salinee Worraphan ◽  
Attalekha Thammata ◽  
Kaweesak Chittawatanarat ◽  
Surasak Saokaew ◽  
Kirati Kengkla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Meta Analysis ◽  
Early Mobilization ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training

scholarly journals Is Omega-3 Fatty Acids Enriched Nutrition Support Safe for Critical Ill Patients? A Systematic Review and Meta-Analysis

Nutrients ◽  
2014 ◽  
Vol 6 (6) ◽  
pp. 2148-2164 ◽  
Author(s):  
Wei Chen ◽  
Hua Jiang ◽  
Zhi-Yuan Zhou ◽  
Ye-Xuan Tao ◽  
Bin Cai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fatty Acids ◽  
Meta Analysis ◽  
Nutrition Support ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Critical Ill Patients ◽  
Critical Ill

scholarly journals Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Eleni Papoutsi ◽  
Vassilis G. Giannakoulis ◽  
Eleni Xourgia ◽  
Christina Routsi ◽  
Anastasia Kotanidou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Meta Analysis ◽  
Mortality And Morbidity ◽  
Icu Admission ◽  
All Cause Mortality ◽  
Detectable Difference

Abstract Background Although several international guidelines recommend early over late intubation of patients with severe coronavirus disease 2019 (COVID-19), this issue is still controversial. We aimed to investigate the effect (if any) of timing of intubation on clinical outcomes of critically ill patients with COVID-19 by carrying out a systematic review and meta-analysis. Methods PubMed and Scopus were systematically searched, while references and preprint servers were explored, for relevant articles up to December 26, 2020, to identify studies which reported on mortality and/or morbidity of patients with COVID-19 undergoing early versus late intubation. “Early” was defined as intubation within 24 h from intensive care unit (ICU) admission, while “late” as intubation at any time after 24 h of ICU admission. All-cause mortality and duration of mechanical ventilation (MV) were the primary outcomes of the meta-analysis. Pooled risk ratio (RR), pooled mean difference (MD) and 95% confidence intervals (CI) were calculated using a random effects model. The meta-analysis was registered with PROSPERO (CRD42020222147). Results A total of 12 studies, involving 8944 critically ill patients with COVID-19, were included. There was no statistically detectable difference on all-cause mortality between patients undergoing early versus late intubation (3981 deaths; 45.4% versus 39.1%; RR 1.07, 95% CI 0.99–1.15, p = 0.08). This was also the case for duration of MV (1892 patients; MD − 0.58 days, 95% CI − 3.06 to 1.89 days, p = 0.65). In a sensitivity analysis using an alternate definition of early/late intubation, intubation without versus with a prior trial of high-flow nasal cannula or noninvasive mechanical ventilation was still not associated with a statistically detectable difference on all-cause mortality (1128 deaths; 48.9% versus 42.5%; RR 1.11, 95% CI 0.99–1.25, p = 0.08). Conclusions The synthesized evidence suggests that timing of intubation may have no effect on mortality and morbidity of critically ill patients with COVID-19. These results might justify a wait-and-see approach, which may lead to fewer intubations. Relevant guidelines may therefore need to be updated.

scholarly journals A systematic review and meta-analysis of the effects of early mobilization therapy in patients after cardiac surgery

Medicine ◽  
2020 ◽  
Vol 99 (4) ◽  
pp. e18843
Author(s):  
Bin Chen ◽  
Xiaofang You ◽  
Yuan Lin ◽  
Danyu Dong ◽  
Xuemin Xie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Meta Analysis ◽  
Early Mobilization

scholarly journals Association Between Glucocorticoids Treatment and Viral Clearance Delay in Patients with COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Jianbo Li ◽  
Xuelian Liao ◽  
Yue Zhou ◽  
Luping Wang ◽  
Hang Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Severity Of Illness ◽  
Viral Clearance ◽  
Cochrane Library ◽  
High Dose ◽  
Hazard Ratios ◽  
Subgroup Analyses ◽  
High Doses ◽  
Critical Ill

Abstract BackgroundEvidence of glucocorticoids on viral clearance delay of COVID-19 patients is not clear. MethodsIn this systematic review and meta-analysis, we searched studies on Medline, Embase, EBSCO, ScienceDirect, Web of Science, Cochrane Library, and ClinicalTrials.gov from 2002 to December 2, 2020. We mainly pooled the adjusted hazard ratios (HRs), mean difference (MD) or risk ratios (RRs) of viral clearance delay and did subgroup analyses by doses and the severity of illness.ResultsOne trial and 38 observational studies, with a total of 7119 patients, were identified. Glucocorticoids treatment was associated with delayed viral clearance in COVID-19 (Adjusted HR 1.71, 95% CI 1.51 to 1.94, I2=22%, PI 1.45 to 2.01), based on moderate-quality evidence. In subgroup analyses, risk of viral clearance delay was significantly higher among COVID-19 patients being mild or moderate ill (adjusted HR 1.94, 95% CI 1.39 to 2.70, I2=52%; MD 2.59, 95% CI 1.21 to 3.97, I2=24%), but not in those of being severe or critical ill (adjusted HR 1.85, 95% CI 1.05 to 3.26; MD 0.22, 95% CI -1.85 to 2.29, I2=56%); taking high doses (adjusted HR 1.49, 95% CI 1.03 to 2.15; unadjusted RR 1.47, 95% CI 1.12 to 1.94) rather taking low doses (adjusted HR 1.39, 95% CI 0.93 to 2.08; unadjusted RR 1.33, 95% CI 1.00 to 1.77) or pulse (unadjusted RR 1.85, 95% CI 0.66 to 5.19).ConclusionsGlucocorticoids treatment delayed viral clearance in COVID-19 patients of being mild or moderate ill or taking a high dose, rather in those of being severe or critical ill or taking low dose or pulse.

Sign in / Sign up

Export Citation Format

Share Document