Central venous pressure monitoring via peripherally or centrally inserted central catheters: a systematic review and meta-analysis

2017 ◽  
Vol 18 (4) ◽  
pp. 273-278 ◽  
Author(s):  
Filippo Sanfilippo ◽  
Alberto Noto ◽  
Gennaro Martucci ◽  
Marco Farbo ◽  
Gaetano Burgio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Central Venous Pressure ◽  
Meta Analysis ◽  
Venous Pressure ◽  
Central Venous ◽  
Clinical Criteria ◽  
Number Of Patients ◽  
The Difference ◽  
Meta Analyses ◽  
Central Catheters

Introduction The central venous pressure (CVP) is the most commonly used static marker of preload for guiding fluid therapy in critically ill patients, though its usefulness remains controversial. Centrally inserted central catheters (CICCs) are the gold-standard devices for CVP monitoring but peripherally inserted central catheters (PICCs) may represent a valid alternative. We undertook a systematic review and meta-analysis with the aim to investigate whether the difference between PICC- and CICC-measured CVP is not significant. Methods We searched for clinical studies published in PubMed and EMBASE databases from inception until December 21st 2016. We included studies providing data on paired and simultaneous CVP measurement from PICCs and CICCs. We conducted two analyses on the values of CVP, the first one according to the total number of CVP assessments, the second one considering the number of patients recruited. Results Four studies matched the inclusion criteria, but only three of them provided data for the meta-analyses. Both analyses showed non-significant differences between PICC-measured and CICC-measured CVP: 1489 paired simultaneous CVP assessments (MD 0.16, 95%CI −0.14, 0.45, p = 0.30) on a total of 57 patients (MD 0.22, 95%CI −1.46, 1.91, p = 0.80). Both analyses showed no heterogeneity (I2 = 0%). Conclusions Available evidence supports that CVP monitoring with PICCs is accurate and reproduces similar values to those obtained from CICCs. The possibility to monitor CVP should not be used among clinical criteria for preferring a CICC over a PICC line.

scholarly journals Central venous pressure and liver resection: a systematic review and meta analysis

HPB ◽  
2015 ◽  
Vol 17 (10) ◽  
pp. 863-871 ◽  
Author(s):  
Michael J. Hughes ◽  
Nicholas T. Ventham ◽  
Ewen M. Harrison ◽  
Stephen J. Wigmore
Keyword(s):  
Systematic Review ◽  
Liver Resection ◽  
Central Venous Pressure ◽  
Meta Analysis ◽  
Venous Pressure ◽  
Central Venous

scholarly journals Ultrasound assessment of central venous pressure: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Jean Deschamps ◽  
Jed Lipes ◽  
Andrew Weinstock ◽  
Dev Jayaraman ◽  
Lawrence Rudski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Central Venous Pressure ◽  
Point Of Care ◽  
Meta Analysis ◽  
Venous Pressure ◽  
Vena Cava ◽  
Correlation Coefficients ◽  
Central Venous ◽  
Care Systems ◽  
Ventilated Patients

Abstract Background Ultrasound is increasingly relied upon to estimate central venous pressure (CVP) in the echocardiography lab and using point-of-care systems in the intensive care unit and the emergency department. However, there is uncertainty regarding the diagnostic accuracy of ultrasound-based parameters as reported in diverse studies.Methods A systematic review was performed by searching MEDLINE, EMBASE, and the Cochrane Database for studies evaluating ultrasound-based indicators of filling pressures in relation to catheterization-based CVP. Studies were screened for predefined inclusion criteria and rated for quality by duplicate observers. Standardized correlation coefficients for each ultrasound-based indicator were meta-analyzed using a random effects model.Results 3949 articles were screened and 64 met the criteria for inclusion. Inferior vena cava (IVC) diameter was assessed in 34 study measures and the pooled standardized correlation with invasive CVP was 0.74 (95% CI 0.63 to 0.84). IVC collapsibility was assessed in 20 study measures and the pooled standardized correlation with invasive CVP was -0.57 (95% CI -0.70 to -0.44). Tricuspid E/Ep was assessed in 6 study measures and the pooled standardized correlation with invasive CVP was 0.59 (95% CI 0.26 to 0.93). IVC parameters but not E/Ep remained correlated with CVP in mechanically ventilated patients, including cardiac surgery patients. Results were similar in studies featuring non-traditional users and cardiac specialists.Conclusions Echocardiographic IVC diameter, collapsibility, and tricuspid E/Ep ratio are significantly correlated with invasive CVP, albeit with important heterogeneity between studies. Most of these indicators are equally valid when applied in ventilated patients and by non-traditional users.

scholarly journals Prevalence of and risk factors for Plasmodium spp. co-infection with hepatitis B virus: a systematic review and meta-analysis

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Kwuntida Uthaisar Kotepui ◽  
Manas Kotepui
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Hepatitis B Virus ◽  
Meta Analysis ◽  
Infection Group ◽  
Pooled Prevalence ◽  
B Virus ◽  
The Difference ◽  
Meta Analyses

Abstract Background Plasmodium spp. and hepatitis B virus (HBV) are among the most common infectious diseases in underdeveloped countries. This study aimed to determine the prevalence of Plasmodium spp. and HBV co-infection in people living in endemic areas of both diseases and to assess the risk factors related to this co-infection. Methods The PubMed, Web of Science, and Scopus databases were searched. Observational cross-sectional studies and retrospective studies assessing the prevalence of Plasmodium species and HBV co-infection were examined. The methodological quality of the included studies was assessed with the Newcastle-Ottawa Scale (NOS), a tool for assessing the quality of nonrandomized studies in meta-analyses, and heterogeneity among the included studies was assessed with Cochran's Q test and the I2 (inconsistency) statistic. The pooled prevalence of the co-infection and its 95% confidence interval (CI) were estimated using the random-effects model, depending on the amount of heterogeneity there was among the included studies. The pooled odds ratio (OR) represented the difference in qualitative variables, whereas the pooled mean difference (MD) represented the difference in quantitative variables. Meta-analyses of the potential risk factors for Plasmodium spp. and HBV co-infection, including patient age and gender, were identified and represented as pooled odds ratios (OR) and 95% CIs. Publication bias among the included studies was assessed by visual inspection of a funnel plot to search for asymmetry. Results Twenty-two studies were included in the present systematic review and meta-analysis. Overall, the pooled prevalence estimate of Plasmodium spp. and HBV co-infection was 6% (95% CI 4–7%, Cochran's Q statistic < 0.001, I2: 95.8%), with prevalences of 10% in Gambia (95% CI: 8–12%, weight: 4.95%), 8% in Italy (95% CI 5–12%, weight: 3.8%), 7% in Nigeria (95% CI 4–10%, weight: 53.5%), and 4% in Brazil (95% CI 2–5%, weight: 19.9%). The pooled prevalence estimate of Plasmodium spp. and HBV co-infection was higher in studies published before 2015 (7%, 95% CI 4–9%, Cochran's Q statistic < 0.001, I2: 96%) than in those published since 2015 (3%, 95% CI 1–5%, Cochran's Q statistic < 0.001, I2: 81.3%). No difference in age and risk of Plasmodium spp. and HBV co-infection group was found between the Plasmodium spp. and HBV co-infection and the Plasmodium monoinfection group (p: 0.48, OR: 1.33, 95% CI 0.60–2.96). No difference in gender and risk of Plasmodium spp. and HBV co-infection group was found between the Plasmodium spp. and HBV co-infection and HBV co-infection group and the Plasmodium monoinfection group (p: 0.09, OR: 2.79, 95% CI 0.86–9.10). No differences in mean aspartate aminotransferase (AST), mean alanine aminotransferase (ALT), or mean total bilirubin levels were found (p > 0.05) between the Plasmodium spp. and HBV co-infection group and the Plasmodium monoinfection group. Conclusions The present study revealed the prevalence of Plasmodium spp. and HBV co-infection, which will help in understanding co-infection and designing treatment strategies. Future studies assessing the interaction between Plasmodium spp. and HBV are recommended.

Pectoralis Major Onlay vs Interpositional Reconstruction Fistulation After Salvage Total Laryngectomy: Systematic Review and Meta-analysis

2020 ◽  
pp. 019459982095796
Author(s):  
Claudia I. Cabrera ◽  
Alexander Joseph Jones ◽  
Noah Philleo Parker ◽  
Amy Emily Lynn Blevins ◽  
Mark S. Weidenbecher
Keyword(s):  
Systematic Review ◽  
Total Laryngectomy ◽  
Primary Closure ◽  
Conservative Therapy ◽  
Meta Analysis ◽  
Pectoralis Major ◽  
Pectoralis Major Flap ◽  
The Difference ◽  
Meta Analyses ◽  
English Articles

Objective To evaluate the difference in pharygocutaneous fistula (PCF) development between pectoralis major flap onlay and interpositional reconstructions after salvage total laryngectomy (STL). Data Sources Medline, Cochrane, Embase, Web of Science, CINAHL, and ClinicalTrials.gov. Review Methods A systematic review was performed during January 2020. English articles were included that described minor and major PCF rates after STL reconstructed with pectoralis major onlay or interposition. PCFs were classified as major when conservative therapy was unsuccessful and/or revision surgery was needed. Articles describing total laryngopharyngectomies were excluded. Meta-analyses of the resulting data were performed. Results Twenty-four articles met final criteria amassing 1304 patients. Three articles compared onlay with interposition, and 18 compared onlay with primary closure. Pectoralis interposition demonstrated elevated odds ratio (OR) of PCF formation as compared with onlay (OR, 2.34; P < .001). Onlay reconstruction reduced overall (OR, 0.32; P < .001) and major (OR, 0.21; P < .001) PCF development as compared with primary pharyngeal closure alone. Data were insufficient to compare interposition against primary closure. Conclusions This research shows evidence that pectoralis onlay after STL diminishes the odds of total and major PCF development. Pectoralis interposition reconstruction showed elevated odds of PCF formation as compared with pectoralis onlay.

scholarly journals Heat-stress-induced changes in central venous pressure do not explain interindividual differences in orthostatic tolerance during heat stress

2011 ◽  
Vol 110 (5) ◽  
pp. 1283-1289 ◽  
Author(s):  
R. Matthew Brothers ◽  
David M. Keller ◽  
Jonathan E. Wingo ◽  
Matthew S. Ganio ◽  
Craig G. Crandall
Keyword(s):  
Blood Pressure ◽  
Heat Stress ◽  
Central Venous Pressure ◽  
Blood Pressure Control ◽  
Lower Body Negative Pressure ◽  
Venous Pressure ◽  
Pressure Control ◽  
Stress Index ◽  
Central Venous ◽  
The Difference

The extent to which heat stress compromises blood pressure control is variable among individuals, with some individuals becoming very intolerant to a hypotensive challenge, such as lower body negative pressure (LBNP) while heat stressed, while others are relatively tolerant. Heat stress itself reduces indexes of ventricular filling pressure, including central venous pressure, which may be reflective of reductions in tolerance in this thermal condition. This study tested the hypothesis that the magnitude of the reduction in central venous pressure in response to heat stress alone is related to the subsequent decrement in LBNP tolerance. In 19 subjects, central hypovolemia was imposed via LBNP to presyncope in both normothermic and heat-stress conditions. Tolerance to LBNP was quantified using a cumulative stress index (CSI), and the difference between normothermic CSI and heat-stress CSI was calculated for each individual. The eight individuals with the greatest CSI difference between normothermic and heat-stress tolerances (LargeDif), and the eight individuals with the smallest CSI difference (SmallDif), were grouped together. By design, the difference in CSI between thermal conditions was greater in the LargeDif group (969 vs. 382 mmHg × min; P < 0.001). Despite this profound difference in the effect of heat stress in decreasing LBNP tolerance between groups, coupled with no difference in the rise in core body temperatures to the heat stress (LargeDif, 1.4 ± 0.1°C vs. SmallDif, 1.4 ± 0.1°C; interaction P = 0.89), the reduction in central venous pressure during heat stress alone was similar between groups (LargeDif: 5.7 ± 1.9 mmHg vs. SmallDif: 5.2 ± 2.0 mmHg; interaction P = 0.85). Contrary to the proposed hypothesis, differences in blood pressure control during LBNP are not related to differences in the magnitude of the heat-stress-induced reductions in central venous pressure.

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