Polymyxin B-immobilised haemoperfusion and mortality in critically ill patients with sepsis/septic shock: a protocol for a systematic review and meta-analysis.
Polymyxin B-immobilised haemoperfusion and mortality in critically ill patients with sepsis/septic shock: a protocol for a systematic review and meta-analysis.
复制标题
DOI：
10.1136/bmjopen-2016-012908
复制
发表时间：
2016-11-21
期刊：
影响因子：
2.9
通讯作者：
Furukawa TA
中科院分区：
文献类型：
--
作者：
Fujii T;Ganeko R;Kataoka Y;Featherstone R;Bagshaw SM;Furukawa TA
多粘菌素B固定血液灌流（PMX-HP）是治疗脓毒症和脓毒性休克的一种有前途的辅助策略。PMX-HP疗法通过在血液灌流期间与多粘菌素固定化纤维结合来清除循环内毒素而起作用。小型临床试验表明，PMX-HP治疗与改善的血液动力学特征、氧合和存活率相关。然而，由于研究设计的局限性（例如，小型、非盲）和普遍性，明确的推断在很大程度上是不确定的。因此，我们建议进行最新的系统评价和证据合成，以描述PMX-HP治疗脓毒症或脓毒性休克成人患者的疗效、安全性和有效性。我们将检索1946年至2016年期间的以下数据库MEDLINE（奥维德）、EMBASE（奥维德）、科克伦图书馆、卫生技术评估数据库（HTA）、护理和相关健康文献累积索引（CINAHL）、PubMed和'Igaku Chuo Zasshi'（ICHUSHI），以寻找PMX-HP在脓毒症或脓毒性休克危重患者中的随机对照试验。电子搜索研究没有语言限制。两名评审员将独立提取数据并评估每个研究的质量。主要结局是28天全因死亡率的合并风险比。还将评价严重不良事件和器官功能障碍评分的变化。次要结局将是90天全因死亡率、血液动力学特征和内毒素水平的变化以及卫生服务的使用。我们的系统综述将综合使用PMX-HP作为脓毒症/脓毒性休克辅助治疗的证据，以改善以患者为中心的生理和卫生服务结果。本审查不要求遵守研究伦理。研究报告将通过同行审查的出版物和会议介绍进行传播。CRD 42016038356。
Polymyxin-B immobilised haemoperfusion (PMX-HP) is a promising adjuvant strategy for the treatment of sepsis and septic shock. PMX-HP therapy works by clearing circulating endotoxin through binding to polymyxin-immobilised fibres during haemoperfusion. Small clinical trials have shown that PMX-HP therapy is associated with improved haemodynamic profile, oxygenation and survival. However, clear inferences have been largely inconclusive due to limitations in study design (eg, small, unblinded) and generalisability. We therefore propose to perform an up-to-date systematic review and evidence synthesis to describe the efficacy, safety and effectiveness of PMX-HP for adult patients with sepsis or septic shock. We will search the following databases from 1946 to 2016 MEDLINE (Ovid), EMBASE (Ovid), Cochrane Library, Health Technology Assessment Database (HTA), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed and ‘Igaku Chuo Zasshi’ (ICHUSHI) for randomised controlled trials of PMX-HP in critically ill patients with sepsis or septic shock. There will be no language restrictions in the electronic search for studies. Two reviewers will extract data and appraise the quality of each study independently. The primary outcome will be the pooled risk ratio of 28-day all-cause mortality. Serious adverse events and changes in organ dysfunction scores will also be evaluated. The secondary outcomes will be 90-day all-cause mortality, changes in haemodynamic profile and endotoxin levels, and health services use. Our systematic review will synthesise the evidence on use of the PMX-HP as an adjuvant therapy in sepsis/septic shock to improve patient-centred, physiological and health services outcomes. Research ethics is not required for this review. The study will be disseminated by peer-reviewed publication and conference presentation. CRD42016038356.
登录
查看更多内容
影响因子：
38.9
作者：
Payen, Didier M.;Guilhot, Joelle;Launey, Yoann;Lukaszewicz, Anne Claire;Kaaki, Mahmoud;Veber, Benoit;Pottecher, Julien;Joannes-Boyau, Olivier;Martin-Lefevre, Laurent;Jabaudon, Matthieu;Mimoz, Olivier;Coudroy, Remi;Ferrandiere, Martine;Kipnis, Eric;Vela, Carlos;Chevallier, Stephanie;Mallat, Jihad;Robert, Rene
通讯作者：
Robert, Rene
影响因子：
6.4
作者：
Marshall, JC;Foster, D;Romaschin, A
通讯作者：
Romaschin, A
影响因子：
9.6
作者：
DANNER, RL;ELIN, RJ;PARILLO, JE
通讯作者：
PARILLO, JE
影响因子：
3.1
作者：
Vincent, JL;Laterre, PF;John, S
通讯作者：
John, S
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N