| Positive end-expiratory pressure, prone positioning, and activated protein C: a critical review of meta-analyses. | |
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MedLine Citation:
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PMID: 21102388 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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The results of meta-analyses on the effectiveness of high positive end-expiratory pressure (PEEP) and prone positioning in acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) are not consistent. In addition, the meta-analyses on the activated protein C in patients with sepsis combine trials with discordant results. Therefore, the aim of this paper was to give a critical review of these meta-analyses. All relevant meta-analyses were identified by a computerized search of PubMed using combinations of the following terms: acute lung injury, acute respiratory distress syndrome, positive end-expiratory pressure, mechanical ventilation, prone position, drotrecogin, activated protein C, sepsis, and septic patients. A high level of PEEP and prone ventilation was shown to reduce the mortality in patients with severe acute hypoxemic respiratory failure. Although the evidence for the efficacy of activated protein C is not conclusive, it should be considered in patients that are at a high risk for death without any contraindications related to bleeding risk. Meta-analysis models can be very useful for clinical decisions if they include all of the similar papers on a medical topic and are correct from the methodological point of view; however, these results must be checked by a careful and well-informed reader. |
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Authors:
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B M Cesana; P Antonelli; D Chiumello; L Gattinoni |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Minerva anestesiologica Volume: 76 ISSN: 1827-1596 ISO Abbreviation: Minerva Anestesiol Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375272 Medline TA: Minerva Anestesiol Country: Italy |
Other Details:
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Languages: eng Pagination: 929-36 Citation Subset: IM |
Affiliation:
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Medical Statistics and Biometry Unit, Department of Biomedical Sciences and Biotechnologies, University of Brescia, Brescia, Italy. cesana@med.unibs.it |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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