适用于成人的体外膜氧化技术:基于系统审查的证据映射
Kai Xie1,2,3, Hui Jing1,2,3, Shengnan Guan1,2,3
1Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China.
European journal of medical research
|April 22, 2024
概括
体外膜氧化 (ECMO) 对各种疾病可能有好处,但系统性审查中的证据质量往往中度至极低. 需要进一步的大规模,多中心的RCT来确认ECMO.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
背景情况:
- 身体外膜氧化 (ECMO) 是严重的心脏和肺衰竭的生命支持技术.
- 关于ECMO的现有系统审查 (SRs) 在质量和所提供的证据方面各不相同.
- 对ECMO的SR进行全面的概述是必要的,以评估报告信息的质量和有效性.
研究的目的:
- 评估关于体外膜氧化 (ECMO) 的现有系统性审查 (SRs) 的方法和证据质量.
- 根据可用的SRs,绘制ECMO的临床主题,证据质量和估计疗效.
主要方法:
- 搜索了四个电子数据库,直到2023年1月,在ECMO上搜索SR.
- 使用多重系统审查评估2 (AMSTAR-2) 工具评估方法质量.
- 通过推评估,开发和评估 (GRADE) 系统对证据质量进行评估.
- 利用泡图来可视化跨临床主题的发现.
主要成果:
- 包括17个涵盖9个临床主题的SR,方法质量从临界低到中等.
- 证据质量各不相同,其中一个SR质量高,另一个SR质量从中等到非常低.
- 对于H1N1流感引起的严重ARDS/ALI,以及对ARDS,ALF/ACLF和心脏骤停的可能益处,ECMO证明了益处;对于某些条件,结论是不确定的.
- 在ECMO和研究的临床主题之间没有发现有害的关联.
结论:
- 有限的高质量证据需要ECMO的大规模,多中心,跨国RCT.
- 大多数临床主题表明ECMO是有益的或可能是有益的.
- 证据映射是呈现治疗干预证据的有效方法.
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