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dc.contributor.authorCronhjort, Maria-
dc.contributor.authorWall, Olof-
dc.contributor.authorNyberg, Erik-
dc.contributor.authorZeng, Ruifeng-
dc.contributor.authorSvensen, Christer-
dc.contributor.authorMårtensson, Johan-
dc.contributor.authorJoelsson-Alm, Eva-
dc.identifier.citationJournal of clinical monitoring and computing 2018; 32(3): 403-414-
dc.description.abstractThe effect of hemodynamic optimization in critically ill patients has been challenged in recent years. The aim of the meta-analysis was to evaluate if a protocolized intervention based on the result of hemodynamic monitoring reduces mortality in critically ill patients. We performed a systematic review and meta-analysis according to the Cochrane Handbook for Systematic Reviews of Interventions. The study was registered in the PROSPERO database (CRD42015019539). Randomized controlled trials published in English, reporting studies on adult patients treated in an intensive care unit, emergency department or equivalent level of care were included. Interventions had to be protocolized and based on results from hemodynamic measurements, defined as cardiac output, stroke volume, stroke volume variation, oxygen delivery, and central venous-or mixed venous oxygenation. The control group had to be treated without any structured intervention based on the parameters mentioned above, however, monitoring by central venous pressure measurements was allowed. Out of 998 screened papers, thirteen met the inclusion criteria. A total of 3323 patients were enrolled in the six trials with low risk of bias (ROB). The mortality was 22.4% (374/1671 patients) in the intervention group and 22.9% (378/1652 patients) in the control group, OR 0.94 with a 95% CI of 0.73-1.22. We found no statistically significant reduction in mortality from hemodynamic optimization using hemodynamic monitoring in combination with a structured algorithm. The number of high quality trials evaluating the effect of protocolized hemodynamic management directed towards a meaningful treatment goal in critically ill patients in comparison to standard of care treatment is too low to prove or exclude a reduction in mortality.-
dc.subjectCritical care-
dc.subjectFluid therapy-
dc.subjectHemodynamic monitoring-
dc.titleImpact of hemodynamic goal-directed resuscitation on mortality in adult critically ill patients: a systematic review and meta-analysis.-
dc.typeJournal Article-
dc.identifier.journaltitleJournal of clinical monitoring and computing-
dc.identifier.affiliationDepartment of Intensive Care, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Anesthesiology, The University of Texas Medical Branch UTMB Health, John Sealy Hospital, Galveston, USAen
dc.identifier.affiliationDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Swedenen
dc.identifier.affiliationUnit of Anaesthesiology and Intensive Care, Södersjukhuset, Stockholm, Swedenen
dc.identifier.affiliationThe Second Hospital and Yuying Children's Hospital, Wenzhou Medical College, Wenzhou, Chinaen
dc.identifier.affiliationSection of Anaesthesia and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Solna, Swedenen
dc.type.austinJournal Article-
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
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