保守氧疗与常规氧疗对ICU患者死亡率的影响:Meta分析。

IF 2.1 4区 医学 Q3 RESPIRATORY SYSTEM
Canadian respiratory journal Pub Date : 2023-10-14 eCollection Date: 2023-01-01 DOI:10.1155/2023/7023712
Xinyu Jiang, Dong Qiu
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引用次数: 0

摘要

目的:比较保守氧疗和常规氧疗对ICU危重患者死亡率的影响。方法:在PubMed、Embase、,Cochrane图书馆、中国知网、VIP和万方,发布日期在2022年8月之前。我们有两名研究人员根据纳入和排除标准评估纳入文献的质量并提取数据,然后使用RevMan 5.4统计软件进行分析。主要转归包括短期死亡率(28天死亡率或ICU死亡率);次要转归包括90天死亡率、ICU住院时间、住院时间、ICU新器官功能障碍发生率、ICU新感染发生率和ICUAW发生率。荟萃分析显示,就短期死亡率而言,保守氧疗比传统氧疗具有优势(P=0.03)。基于不同保守氧靶点的亚组分析显示,当靶点设定在90%以上时,这种优势具有统计学意义(RR = 0.76,95%CI = 0.62~0.94,P=0.01),而当目标设定在90%以下时,保守氧疗和常规氧疗之间没有显著差异(RR = 0.95,95%CI = 0.79~1.16,P=0.63)。此外,在ICU新感染的发生率(P=0.03)和ICUAW的发生率方面,保守氧疗也比传统氧疗有优势,差异具有统计学意义。但就90天死亡率(P=0.61)、ICU住院时间(P=0.96)、住院时间(P=0.047)和ICU新器官功能障碍发生率(P=0.61%)而言,保守氧疗与常规氧疗之间没有显著差异。结论:与常规氧疗相比,保守氧疗可以降低重症患者的短期死亡率,尤其是当保守氧疗目标设定在90%以上时。它还可以降低ICU新感染和ICUAW的发生率,同时对90天死亡率、ICU住院时间和住院时间没有影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Effects of Conservative Oxygen Therapy versus Conventional Oxygen Therapy on the Mortality in ICU Patients: A Meta-Analysis.

Effects of Conservative Oxygen Therapy versus Conventional Oxygen Therapy on the Mortality in ICU Patients: A Meta-Analysis.

Effects of Conservative Oxygen Therapy versus Conventional Oxygen Therapy on the Mortality in ICU Patients: A Meta-Analysis.

Objective: To compare the effects of conservative oxygen therapy and conventional oxygen therapy on the mortality of critically ill patients in ICU.

Methods: Searching for randomized controlled clinical trials (RCT) on the effect of conservative oxygen therapy and conventional oxygen therapy on the mortality of critically ill patients in computer databases, including PubMed, Embase, Cochrane Library, CNKI, VIP, and Wanfang, with postdate before August 2022. We have two researchers evaluating the quality of the literature included and extracting data as per the inclusion and exclusion criteria and then analyzed it with RevMan 5.4 statistical software. Primary outcome included short-term mortality (28-day mortality or ICU mortality); secondary outcome included 90-day mortality, ICU length of stay, hospital length of stay, incidence of new organ dysfunction in ICU, incidence of new infection in ICU, and incidence of ICUAW.

Results: A total of 5779 subjects were included in 10 articles, including 2886 in the conservative oxygen therapy group and 2893 in the conventional oxygen therapy group. The meta-analysis showed that conservative oxygen therapy had an advantage over conventional oxygen therapy in terms of short-term mortality (P=0.03). Subgroup analysis based on different conservative oxygen targets showed that this advantage was statistically significant when the target is set above 90% (RR = 0.76, 95% CI = 0.62∼0.94, P=0.01), while there was no significant difference between conservative oxygen therapy and conventional oxygen therapy when the target is set below 90% (RR = 0.95, 95% CI = 0.79∼1.16, P=0.63). In addition, in terms of the incidence of new infections in the ICU (P=0.03) and the incidence of ICUAW (P=0.03), conservative oxygen therapy also had advantages over conventional oxygen therapy, and the difference was statistically significant. But in terms of 90-day mortality (P=0.61), ICU length of stay (P=0.96), hospital length of stay (P=0.47), and incidence of new organ dysfunction in ICU (P=0.61), there was no significant difference between conservative oxygen therapy and conventional oxygen therapy.

Conclusion: Compared with conventional oxygen therapy, conservative oxygen therapy can reduce the short-term mortality of severe patients, especially when the conservative oxygen therapy target is set above 90%. And it can also reduce the incidence of ICU new infections and ICUAW, while having no effect on 90-day mortality, ICU length of stay, and hospital length of stay.

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来源期刊
Canadian respiratory journal
Canadian respiratory journal 医学-呼吸系统
CiteScore
4.20
自引率
0.00%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.
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