在重症患者中预防胃肠道出血的质子抑制剂:系统性审查协议
Ying Wang1, Diane Heels-Ansdell1, Long Ge2
1Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
质子抑制剂 (PPI) 常用于重症患者,但本次审查考察了它们的风险和益处. 我们将分析试验,以确定PPI是否安全有效地预防胃肠道出血.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 胃肠病学 胃肠病学
背景情况:
- 质子抑制剂 (PPI) 广泛用于预防严重病患者上部胃肠道出血.
- 人们对 PPI 的潜在危害存在担忧,包括肺炎的风险增加,Clostridioides difficile 感染,以及重病患者的死亡率.
- 即将到来的REVISE试验将在机械通风患者中比较潘托普拉与安慰剂,这促使了这一系统性审查.
研究的目的:
- 系统地审查随机试验,比较PPI与安慰剂或无胃肠道出血的预防在重症监护室 (ICU) 的成年人.
- 评估PPI在重症患者中的有效性和安全性.
- 提供关于使用PPI用于压力预防的最新证据.
主要方法:
- 对随机试验进行系统的文献搜索,将PPI与ICU成年人的安慰剂/无预防药物进行比较.
- 两个审稿人的独立数据提取和偏差风险评估.
- 使用随机效应模型的元分析,计算相对风险和平均差异,以95%的置信区间.
- 根据患者的严重程度,对PPI对死亡率的影响进行子组分析.
- 使用GRADE方法进行证据评估的确定性.
主要成果:
- 这个部分是在研究完成后填写的.
结论:
- 这一系统性审查将提供最新的证据,说明在当前医疗实践中使用PPI用于重症患者的压力预防的优点和缺点.
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