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Higher versus lower fractions of inspired oxygen or targets of arterial oxygenation for adults admitted to the intensive care unit
CONCLUSIONS: In adult ICU patients, it is still not possible to draw clear conclusions about the effects of higher versus lower oxygenation strategies on all-cause mortality, SAEs, quality of life, lung injuries, myocardial infarction, stroke, and sepsis at maximum follow-up. This is due to low or very low-certainty evidence.PMID:37700687 | DOI:10.1002/14651858.CD012631.pub3
Source: Cochrane Database of Systematic Reviews - September 13, 2023 Category: General Medicine Authors: Thomas L Klitgaard Olav L Schj ørring Frederik M Nielsen Christian S Meyhoff Anders Perner J ørn Wetterslev Bodil S Rasmussen Marija Barbateskovic Source Type: research

Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery
CONCLUSIONS: In some types of elective surgery, cell salvage may reduce the need for and volume of allogeneic transfusion, alongside evidence of no difference in adverse events, when compared to no cell salvage. Further research is required to establish why other surgeries show no benefit from CS, through further analysis of the current evidence. More large RCTs in under-reported specialities are needed to expand the evidence base for exploring the impact of CS.PMID:37681564 | PMC:PMC10486190 | DOI:10.1002/14651858.CD001888.pub5
Source: Cochrane Database of Systematic Reviews - September 8, 2023 Category: General Medicine Authors: Thomas D Lloyd Louise J Geneen Keeley Bernhardt William McClune Scott J Fernquest Tamara Brown Carolyn Dor ée Susan J Brunskill Michael F Murphy Antony Jr Palmer Source Type: research

Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for adults with early (stage 1 to 3) non-diabetic chronic kidney disease
CONCLUSIONS: There is currently insufficient evidence to determine the effectiveness of ACEi or ARB in patients with stage 1 to 3 CKD who do not have DM. The available evidence is overall of very low certainty and high risk of bias. We have identified an area of large uncertainty for a group of patients who account for most of those diagnosed as having CKD.PMID:37466151 | DOI:10.1002/14651858.CD007751.pub3
Source: Cochrane Database of Systematic Reviews - July 19, 2023 Category: General Medicine Authors: Tess E Cooper Claris Teng David J Tunnicliffe Brydee A Cashmore Giovanni Fm Strippoli Source Type: research

Pharmacological interventions for the prevention of bleeding in people undergoing definitive fixation or joint replacement for  hip, pelvic and long bone fractures
CONCLUSIONS: We cannot draw conclusions from the current evidence due to lack of data. Most published studies included in our analyses assessed the use of tranexamic acid (compared to placebo, or using different routes of administration). We identified 27 prospectively registered ongoing RCTs (total target recruitment of 4177 participants by end of 2023). The ongoing trials create six new comparisons: tranexamic acid (tablet + injection) versus placebo; intravenous tranexamic acid versus oral tranexamic acid; topical tranexamic acid versus oral tranexamic acid; different intravenous tranexamic acid dosing regimes; topical ...
Source: Cochrane Database of Systematic Reviews - June 5, 2023 Category: General Medicine Authors: Victoria N Gibbs Rita Champaneria Louise J Geneen Parag Raval Carolyn Dor ée Susan J Brunskill Alex Novak Antony Jr Palmer Lise J Estcourt Source Type: research

Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis
CONCLUSIONS: The comparative effects of different ESAs on blood transfusions, death (any cause and cardiovascular), major cardiovascular events, myocardial infarction, stroke, vascular access thrombosis, kidney failure, fatigue and breathlessness were uncertain.PMID:36791280 | PMC:PMC9924302 | DOI:10.1002/14651858.CD010590.pub3
Source: Cochrane Database of Systematic Reviews - February 15, 2023 Category: General Medicine Authors: Edmund Ym Chung Suetonia C Palmer Valeria M Saglimbene Jonathan C Craig Marcello Tonelli Giovanni Fm Strippoli Source Type: research

Remote ischaemic preconditioning versus no remote ischaemic preconditioning for vascular and endovascular surgical procedures
CONCLUSIONS: Overall, compared with no RIPC, RIPC probably leads to little or no difference in perioperative mortality, myocardial infarction, renal impairment, stroke, hospital stay, and operating time, and may lead to little or no difference in limb loss in people undergoing elective major vascular and endovascular surgery. Adequately powered and designed randomised studies are needed, focusing in particular on the clinical endpoints and patient-centred outcomes.PMID:36645250 | DOI:10.1002/14651858.CD008472.pub3
Source: Cochrane Database of Systematic Reviews - January 16, 2023 Category: General Medicine Authors: Fuxiang Liang Shidong Liu Guangzu Liu Hongxu Liu Bing Song Liang Yao Qi Wang Source Type: research

Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack
CONCLUSIONS: Peroxisome proliferator-activated receptor gamma agonists probably reduce recurrent stroke and total events of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke, and may improve insulin sensitivity and the stabilisation of carotid plaques. Their effects on adverse events are uncertain. Our conclusions should be interpreted with caution considering the small number and the quality of the included studies. Further well-designed, double-blind RCTs with large samples are required to assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular...
Source: Cochrane Database of Systematic Reviews - January 10, 2023 Category: General Medicine Authors: Jia Liu Lu-Ning Wang Source Type: research

High versus low blood pressure targets for cardiac surgery while on cardiopulmonary bypass
CONCLUSIONS: A high blood pressure target may result in little to no difference in patient outcomes including acute kidney injury and mortality. Given the wide CIs, further studies are needed to confirm the efficacy of a higher blood pressure target among those who undergo cardiac surgery with CPB.PMID:36448514 | DOI:10.1002/14651858.CD013494.pub2
Source: Cochrane Database of Systematic Reviews - November 30, 2022 Category: General Medicine Authors: Yuki Kotani Yuki Kataoka Junichi Izawa Shoko Fujioka Takuo Yoshida Junji Kumasawa Joey Sw Kwong Source Type: research

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