平衡与盐水试验者的协议:随机对照试验的活体系统审查和个体患者数据元分析 (BEST-Living研究)
Fernando G Zampieri1,2,3, Alexandre B Cavalcanti1,2, Gian Luca Di Tanna4
1HCor Research Institute, São Paulo, Brazil.
概括
这一活体系统综述和元分析调查了与盐水相比,平衡的解决方案是否可以改善危急病患者的治疗结果. 它旨在提供关于它们的有效性和潜在危害的全面证据.
科学领域:
- 关键护理医学 关键护理医学
- 流体疗法是一种流体疗法.
- 系统性审查和元分析
背景情况:
- 危急病患者的最佳静脉注射液仍在争论中,关于平衡晶体溶液与0.9%盐溶液的比较有效性存在不确定性.
- 现有证据表明平衡解决方案的潜在好处,但跨患者群体治疗效果的异质性需要进一步调查.
研究的目的:
- 进行持续的活体系统审查和个人患者数据元分析 (IPDMA),比较严重病情的成年人的平衡溶液和盐水.
- 综合评估患者为中心的结局,包括死亡率和生存率的证据总和.
- 调查不同患者子组之间治疗效果的潜在异质性.
主要方法:
- 包括在重症监护室 (ICU) 的成年人随机对照试验 (RCT),比较平衡的晶化物与0.9%的盐水.
- 每年在多个数据库 (MEDLINE,EMBASE,CENTRAL等) 进行文献搜索. 并邀请作者提供个别患者数据.
- 使用随机效应贝叶斯元分析和IPDMA等级贝叶斯模型合成数据.
主要成果:
- 主要终点是住院死亡率;关键的次要终点是随访时间最长的存活率.
- 分析将包括符合条件的RCT的综合和个体患者数据.
- 结果将定期更新,因为通过生活审查过程可以获得新的数据.
结论:
- 均衡的结晶体溶液可以在特定的重症患者群体中提供生存益处并改善其他结果.
- 这个活生生的系统性审查和IPDMA将提供最新的,全面的证据评估.
- 结果将为临床实践指南提供有关重症监护中的流体管理的信息.
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