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Titolo:
The incidence of major morbidity in critically ill patients managed with pulmonary artery catheters: A meta-analysis
Autore:
Ivanov, R; Allen, J; Calvin, JE;
Indirizzi:
Rush Presbyterian St Lukes Med Ctr, Sect Crit Care Med, Chicago, IL 60612 USA Rush Presbyterian St Lukes Med Ctr Chicago IL USA 60612 ago, IL 60612 USA
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 3, volume: 28, anno: 2000,
pagine: 615 - 619
SICI:
0090-3493(200003)28:3<615:TIOMMI>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
MAXIMIZING OXYGEN DELIVERY; RANDOMIZED CLINICAL-TRIAL; RISK SURGICAL PATIENTS; SUPRANORMAL VALUES; ORGAN FAILURE; SEVERE TRAUMA; END-POINTS; RESUSCITATION; MORTALITY; COMPLICATIONS;
Keywords:
meta-analysis; morbidity; pulmonary artery catheterization; right heart catheterization; systematic review;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
23
Recensione:
Indirizzi per estratti:
Indirizzo: Calvin, JE Rush Presbyterian St Lukes Med Ctr, Sect Crit Care Med, 1653 W Congress Pkwy,214 Jones, Chicago, IL 60612 USA Rush Presbyterian St Lukes Med Ctr 1653 W Congress Pkwy,214 Jones Chicago IL USA 60612
Citazione:
R. Ivanov et al., "The incidence of major morbidity in critically ill patients managed with pulmonary artery catheters: A meta-analysis", CRIT CARE M, 28(3), 2000, pp. 615-619

Abstract

Introduction: The impact of pulmonary artery (PA) catheters on patient outcome has been questioned and their usage has become controversial. Meta-analysis on mortality has shown a trend for improved survival with PA catheter-guided therapy. We now perform a meta-analysis on morbidity from PA catheters in the published literature. Methods: We did a search of the medical database (Medline) from 1970 through 1996, using the headings "pulmonary artery catheterization," "Swan-Ganz catheterization" and "right heart catheterization," and restricting the results to "effectiveness" end "usefulness. " We also consulted with other experts regarding published randomized controlled trials (RCTs). This yielded 16 RCTs addressing the question of effectiveness of PA catheter-guided treatment. Of these, 12 were found to include data on morbidity. Major morbidity, defined as organ failures as per the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference criteria, from these trials was entered into a formal meta-analysis. Results: A total of 1,610 patients from the 12 trials were analyzed. Morbidity events were observed in 62.77% of the PA catheter treatment group, andin 74.34% of the control group. A relative risk ratio of 0.78074 was obtained, with a 95% confidence interval of 0.6459-0.94374 and a corresponding pof .0168, a lower morbidity in the PA catheter treatment group. Those withPA catheter-guided treatment had a mean protective effect of 21.9% for risk of morbidity. Other important covariates such as acuity of illness, quality score of trials, year of publication, type of PA catheter-guided treatment used (PA catheter vs. no PA catheter, or PA catheter vs. PA catheter forsupranormal hemodynamic values), and surgical or mixed patient population,all increased variability and were not statistically significant predictors for risk ratio of morbidity. Conclusions: Meta-analysis of RCTs included in this study shows that thereis a statistically significant reduction in morbidity using PA catheter-guided strategies.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 11:09:56