Rehabilitation for patients with sepsis: A systematic review and meta-analysis.
Rehabilitation for patients with sepsis: A systematic review and meta-analysis.
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DOI：
10.1371/journal.pone.0201292
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Tsujimoto Y
中科院分区：
文献类型：
--
作者：
Taito S;Taito M;Banno M;Tsujimoto H;Kataoka Y;Tsujimoto Y
本系统评价的目的是确定康复治疗是否影响成人脓毒症患者的临床相关结局。从科克伦对照试验中心注册库（CENTRAL）、MEDLINE、EMBASE、护理和相关健康文献累积索引（CINAHL）、PEDro和世界卫生组织国际临床试验平台搜索门户网站以及相关文章的会议记录和参考文献列表中收集随机对照试验。两位评审员独立确定了关于脓毒症患者康复的随机对照试验，两位评审员独立提取了试验水平数据，包括人群特征，干预措施，比较和临床结局。我们的主要结果是生活质量（QOL），日常生活活动（ADL）和死亡率。我们的次要结局是住院时间、恢复工作、肌肉力量、谵妄和所有不良事件。证据的质量是使用建议评估、发展和评价分级（GRADE）方法确定的。我们纳入了两项试验，共招募了75名患者。SF-36测量的身体功能和身体角色在QOL中的平均差异（95%置信区间[CI]）分别为21.10（95% CI：6.57-35.63）和44.40（95% CI：22.55-66.05）。康复治疗并未显著降低重症监护室（ICU）死亡率（风险比，2.02 [95%CI：0.46-8.91]，I2 = 0%; n = 75）。ICU住院时间和住院时间以及肌肉力量无统计学显著差异，两项研究均未报告不良事件。这些结果的证据的确定性“非常低”。在任何试验中均未获得关于ADL、重返工作岗位和谵妄的数据。脓毒症患者的康复可能不会降低ICU死亡率，但可能会改善生活质量。此外，需要设计良好的试验来测量重要的结果，以确定脓毒症患者康复的益处和危害。
The objective of this systematic review was to determine whether rehabilitation impacts clinically relevant outcomes among adult patients with sepsis. Randomized controlled trials from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PEDro, and the World Health Organization International Clinical Trials Platform Search Portal, as well as conference proceedings and reference lists of relevant articles were collected. Two reviewers independently identified randomized controlled trials on the rehabilitation of patients with sepsis, and the two reviewers independently abstracted trial level data including population characteristics, interventions, comparisons, and clinical outcomes. Our primary outcomes were quality of life (QOL), activity of daily living (ADL), and mortality. Our secondary outcomes were length of stay, return to work, muscle strength, delirium, and all adverse events. The quality of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. We included two trials enrolling 75 patients. The mean difference (95% confidence interval [CI]) of physical function and physical role in QOL measured by SF-36 were 21.10 (95% CI: 6.57–35.63) and 44.40 (95% CI: 22.55–66.05), respectively. Rehabilitation did not significantly decrease intensive care unit (ICU) mortality (risk ratio, 2.02 [95% CI: 0.46–8.91], I2 = 0%; n = 75). ICU length of stay and hospital length of stay and muscle strength were not statistically significantly different and no adverse events were reported in both studies. The certainty of the evidence for these outcomes was “very low.” Data on ADL, return to work, and delirium were not available in any of the trials. Rehabilitation of patients with sepsis might not decrease ICU mortality, but might improve QOL. Further, well-designed trials measuring important outcomes will be needed to determine the benefit and harm of rehabilitation among patients with sepsis.
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影响因子：
3.7
作者：
Battle CE;Davies G;Evans PA
通讯作者：
Evans PA
影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
8.8
作者：
Fan E;Dowdy DW;Colantuoni E;Mendez-Tellez PA;Sevransky JE;Shanholtz C;Himmelfarb CR;Desai SV;Ciesla N;Herridge MS;Pronovost PJ;Needham DM
通讯作者：
Needham DM
影响因子：
38.9
作者：
Garnacho-Montero, J;Madrazo-Osuna, J;Moyano-Del-Estad, MR
通讯作者：
Moyano-Del-Estad, MR
DOI：
10.1164/rccm.201206-1022cp
发表时间：
2012-12-15
影响因子：
24.7
作者：
Hopkins, Ramona O.;Suchyta, Mary R.;Needham, Dale
通讯作者：
Needham, Dale