19 research outputs found
Normal saline versus heparin for patency of central venous catheters in adult patients - a systematic review and meta-analysis
Effect of Chlorhexidine/Silver Sulfadiazine-Impregnated Central Venous Catheters in an Intensive Care Unit with a Low Blood Stream Infection Rate after Implementation of an Educational Program: A Before鈥揂fter Trial
Effectiveness of heparin versus 0.9% saline solution in maintaining the permeability of central venous catheters: a systematic review
Noninvasive ventilation with helmet versus control strategy in patients with acute respiratory failure: a systematic review and meta-analysis of controlled studies
Toward mitigating pressure injuries: Detecting patient orientation from vertical bed reaction forces
Can Flush and Lock Solutions Used in Human Medicine Be Applied to Large Animal IV Therapy: A Systematic Review
Is there evidence to support the use of lateral positioning in intensive care? A systematic review
A systematic review of randomised clinical trials was conducted to investigate the efficacy and safety of use of the lateral position in the management of ventilated intensive care patients. One review article and I I empiric studies, which were mostly of low methodological quality, met the eligibility criteria. Large individual variations in PaO2 response to lateral positioning were demonstrated. Greatest improvement in PaO2 occur-red in patients with unilateral pulmonary infiltrates positioned with the bad lung tip versus bad lung down (average difference =33.6 mmHg (range 0-58), effect size 1.13 (95% Cl: 0.44, 1.19, P=0.001)) or supine (average difference=27 mmHg (range 5-42), effect size 0.58 (95% Cl: 0.11, 1.06, P=0.017)). This effect appeared to be most prominent in patients with widespread, unilateral infiltrates. Lung compliance was not affected by lateral positioning. Haemodynamic compromise was evident with lateral positioning of greater than 60 degrees to the right side in patients requiting vasopressors and/or with right ventricular dysfunction; or with lateral positioning in postoperative coronary artery bypass graft patients. No studies were found that had investigated the effect of routine applications of the lateral positioning to improve, prevent or treat pneumonia, decrease mortality or influence other long-term outcomes. The results of this review demonstrate the limited evidence available to support the use of lateral positioning in the intensive care environment. More data reporting the long-term effects of lateral position on long-term outcomes would aid clinical decision making and may improve the application of patient positioning in critical care environments