A Systematic Review and International Web-Based Survey of Randomized Controlled Trials in the Perioperative and Critical Care Setting: Interventions Reducing Mortality

Sartini, Chiara and Lomivorotov, Vladimir and Pieri, Marina and Lopez-Delgado, Juan Carlos and Baiardo Redaelli, Martina and Hajjar, Ludhmila and Pisano, Antonio and Likhvantsev, Valery and Fominskiy, Evgeny and Bradic, Nikola and Cabrini, Luca and Novikov, Maxim and Avancini, Daniele and Riha, Hynek and Lembo, Rosalba and Gazivoda, Gordana and Paternoster, Gianluca and Wang, Chengbin and Tamà, Simona and Alvaro, Gabriele and Wang, Chew Yin and Roasio, Agostino and Ruggeri, Laura and Yong, Chow-Yen and Pasero, Daniela and Severi, Luca and Pasin, Laura and Mancino, Giuseppe and Mura, Paolo and Musu, Mario and Spadaro, Savino and Conte, Massimiliano and Lobreglio, Rosetta and Silvetti, Simona and Votta, Carmine Domenico and Belletti, Alessandro and Di Fraja, Diana and Corradi, Francesco and Brusasco, Claudia and Saporito, Emanuela and D'Amico, Alessandro and Sardo, Salvatore and Ortalda, Alessandro and Riefolo, Claudio and Fabrizio, Monaco and Zangrillo, Alberto and Bellomo, Rinaldo and Landoni, Giovanni (2019) A Systematic Review and International Web-Based Survey of Randomized Controlled Trials in the Perioperative and Critical Care Setting: Interventions Reducing Mortality. Journal of Cardiothoracic and Vascular Anesthesia, 33 (5). pp. 1430-1439. ISSN 1053-0770, DOI https://doi.org/10.1053/j.jvca.2018.11.026.

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Official URL: https://doi.org/10.1053/j.jvca.2018.11.026


The authors aimed to identify interventions documented by randomized controlled trials (RCTs) that reduce mortality in adult critically ill and perioperative patients, followed by a survey of clinicians’ opinions and routine practices to understand the clinicians’ response to such evidence. The authors performed a comprehensive literature review to identify all topics reported to reduce mortality in perioperative and critical care settings according to at least 2 RCTs or to a multicenter RCT or to a single-center RCT plus guidelines. The authors generated position statements that were voted on online by physicians worldwide for agreement, use, and willingness to include in international guidelines. From 262 RCT manuscripts reporting mortality differences in the perioperative and critically ill settings, the authors selected 27 drugs, techniques, and strategies (66 RCTs, most frequently published by the New England Journal of Medicine [13 papers], Lancet [7], and Journal of the American Medical Association [5]) with an agreement ≥67% from over 250 physicians (46 countries). Noninvasive ventilation was the intervention supported by the largest number of RCTs (n = 13). The concordance between agreement and use (a positive answer both to “do you agree” and “do you use”) showed differences between Western and other countries and between anesthesiologists and intensive care unit physicians. The authors identified 27 clinical interventions with randomized evidence of survival benefit and strong clinician support in support of their potential life-saving properties in perioperative and critically ill patients with noninvasive ventilation having the highest level of support. However, clinician views appear affected by specialty and geographical location. © 2018 Elsevier Inc.

Item Type: Article
Uncontrolled Keywords: mortality; anesthesia; consensus conference; critically ill; survival; intensive care; perioperative; democracy-based medicine
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 22 Jan 2020 01:17
Last Modified: 22 Jan 2020 01:17
URI: http://eprints.um.edu.my/id/eprint/23518

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