Chlorhexidine-Related Mortality Rate in Critically Ill Subjects in Intensive Care Units: A Systematic Review and Meta-Analysis.

BACKGROUND: This meta-analysis aimed to explore the chlorhexidine-related mortality rate for subjects on mechanical ventilation and in an ICU when compared with subjects who received standard ICU care. METHODS: We searched a number of medical literature databases and the first 100 results in an inte...

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Publicado en:Respiratory Care Vol. 64; no. 3; pp. 338 - 351
Autores principales: Sojung Lee, Lighvan, Nima Laghapour, McCredie, Victoria, Pechlivanoglou, Petros, Krahn, Murray, Quiñonez, Carlos, Azarpazhooh, Amir
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Mar2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2019
      vid: 64
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      pub: Mary Ann Liebert, Inc.
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        atl: Chlorhexidine-Related Mortality Rate in Critically Ill Subjects in Intensive Care Units: A Systematic Review and Meta-Analysis.
      aug:
        au:
          Sojung Lee
          Lighvan, Nima Laghapour
          McCredie, Victoria
          Pechlivanoglou, Petros
          Krahn, Murray
          Quiñonez, Carlos
          Azarpazhooh, Amir
        affil: Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
      sug:
        subj:
          Pneumonia, Ventilator-Associated Drug Therapy
          Chlorhexidine Administration and Dosage
          Hospital Mortality
          Critically Ill Patients
          Intensive Care Units
          Human
          Systematic Review
          Meta Analysis
          Medline
          Embase
          Respiration, Artificial
          Mantel-Haenszel Test
          Chi Square Test
      ab: BACKGROUND: This meta-analysis aimed to explore the chlorhexidine-related mortality rate for subjects on mechanical ventilation and in an ICU when compared with subjects who received standard ICU care. METHODS: We searched a number of medical literature databases and the first 100 results in an internet search. Two of us independently reviewed the titles and abstracts of the identified articles. Then general and specific characteristics from eligible articles were extracted and the quality of included trials were appraised by using a risk of bias assessment tool. Risk ratios were calculated, together with the 95% CI. Random-effects models with the Mantel-Haenszel method were used to estimate pooled probabilities. Heterogeneity was identified and quantified via the chi square test and I² values, respectively. RESULTS: Eleven of the 547 studies were suitable for this meta-analysis. The included participants were critically ill adults in ICU settings of high-income countries (n = 1157) and low/middle-income countries (n= 612). They were assigned to either the chlorhexidine or control groups. Overall, moderate-quality evidence indicated reduced ventilator-associated pneumonia incidence (for high-income countries: RR 0.60, 95% CI 0.41- 0.87; P= .008; I² = 39%; and for low- and middle-income countries: RR 0.71, 95% CI 0.51- 0.99; P=_ .05; I² = 10%), without a substantial effect on mortality rate (for high-income countries: RR 1.01, 95% CI 0.65-1.57; P= .96; I² = 42%; and for low- and middle-income countries: RR 1.11, 95% CI 0.96 -1.29; P = .17; I² = 0%). CONCLUSIONS: The prophylactic administration of chlorhexidine among patients who were critically ill and in an ICU setting reduced the occurrence of ventilator-associated pneumonia with no significant impact on associated mortality.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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